Sheep reversal using protamine sulfate (P.S).
In 1990 literature describes ability to slowly inject (over 30 min) P.S. to reverse heparin (Anesthesiology. 1990 Sep;73(3):415-24). In May 1988, (Circ Res. 1988 May;62(5):905-15), authors discussing possible reasons why sheep reacts: “Acute pulmonary vasoconstriction and thromboxane release during protamine reversal of heparin anticoagulation in awake sheep. Evidence for the role of reactive oxygen metabolites following nonimmunological complement activation”.
Many surgical groups have then switched to LMWH when performing cardiac procedures like in the submission in 2015 by Dr. Schmitt from Pediatric Cardiology from Berlin Heart: entitled” Administration of Dalteparin in Sheep for Cardiac Interventions”.
A) Is there any published literature/or empirically tested (unpublished) about Dalteparin reversal using Protamine Sulfate, in terms of dosages of P.S, and its timing and proper monitoring including P.S. titration that can be easily performed in the animal OR?
B) Is there any literature about P.S. reversal of any other LMWH used in sheep cardiac procedures?
Hello Filip Konecny
please check pdfs and links
http://www.ncbi.nlm.nih.gov/pubmed/21959588
http://link.springer.com/article/10.1007%2Fs11239-013-0927-7
http://www.uptodate.com/contents/heparin-and-lmw-heparin-dosing-and-adverse-effects
http://link.springer.com/article/10.1007/BF00232022
http://reference.medscape.com/drug/protamine-343746
thank you, some of your attached articles have interesting scientific information I can use to look for a dose. Thank you again,
Filip
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