title: Reversal of heparin after cardiac surgery: protamine titration using a statistical model.
abstract: OBJECTIVE
  To establish a statistical model for determination of protamine dose in conjunction with cardiopulmonary bypass.
  
  
  METHODS
  Prospective.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Ninety consecutive cardiac surgical patients.
  
  
  METHODS
  None.
  
  
  RESULTS
  A series of clinically oriented variables were introduced into a statistical model for projection of the protamine dose after cardiopulmonary bypass. The following significant predictors were identified using multivariable regression analysis: The patient's body surface area, the administered dose of heparin, heparin clearance, and the preoperative platelet count. The statistical model projected the protamine dose within 3±23 mg of the point-of-care test used as reference.
  
  
  CONCLUSIONS
  Protamine dosing based on statistical modeling represents an alternative to point-of-care tests.
authors: Department of Surgical & Perioperative Science, Heart Centre Umeå University, Umeå, Sweden.
authors: Fredrik Ödling
authors: FÖ
authors: Davidsson
authors: Department of Surgical & Perioperative Science, Heart Centre Umeå University, Umeå, Sweden.
authors: Daniel
authors: D
authors: Johagen
authors: Department of Surgical & Perioperative Science, Heart Centre Umeå University, Umeå, Sweden.
authors: Micael
authors: M
authors: Appelblad
authors: Department of Surgical & Perioperative Science, Heart Centre Umeå University, Umeå, Sweden. Electronic address: staffan.svenmarker@vll.se.
authors: Staffan
authors: S
authors: Svenmarker
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000639:trends*; D005260:Female; D006493:Heparin / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D006494:Heparin Antagonists / Q000008:administration & dosage* / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D019095:Point-of-Care Systems; D011446:Prospective Studies; D011479:Protamines / Q000008:administration & dosage* / Q000097:blood
chemical_list: D006494:Heparin Antagonists; D011479:Protamines; D006493:Heparin
keywords: cardiac surgery; cardiopulmonary bypass; heparin; point-of-care testing; protamine; statistical modeling