Protamine is currently used during cardiac surgery to neutralize unfractionated heparin (UFH) at the end of extra-corporeal circulation (ECC). The optimal dose of protamine is currently unknown, and the administration of protamine is done empirically. Protamine and UFH pharmacokinetics are characterized by a large inter-individual variability. A dose of protamine proportional to the amount of UFH administrated during the surgery may be therefore not adapted to most of the patients and exposed them to a risk of under or over dosage. In this study, research investigators hypothesize that an accurate characterization of the pharmacokinetic/pharmacodynamic (PK/PD) relationship of protamine may help to optimize propose an optimal dosing regimen.
Study Type
OBSERVATIONAL
Enrollment
70
PK/ PD protamine
CHU Saint-Etienne
Saint-Etienne, France
PK/PD Protamine
Pharmacokinetics (PK) : plasma concentration of protamine measured by liquid chromatography coupled with mass spectrometry. Pharmacodynamics (PD) :The effect of protamine corresponds to the kinetics of the disappearance of UFH in the blood. To do this, the investigators measure its concentration using an anti-Xa activity measurement technique.
Time frame: 1 day
PK/PD Protamine
PK: evolution of protamine concentrations over time (plasma concentration of protamine measured by liquid chromatography coupled with mass spectrometry). PD: ts neutralizing effect evaluated by thrombinography .
Time frame: 1 day
postoperative blood loss:
quantities of blood loss in pleural and mediastinal drains during the first 24 hours postoperatively.
Time frame: 1 day
ratios between the amount of UFH present at the protamine injection and the dose of protamine administered.
Time frame: 1 day
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