Reversal of heparin anticoagulation by recombinant platelet factor 4 and protamine sulfate in baboons during cardiopulmonary bypass Alvise Bernabei,

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Presentation transcript:

Reversal of heparin anticoagulation by recombinant platelet factor 4 and protamine sulfate in baboons during cardiopulmonary bypass Alvise Bernabei, MD (by invitation), Nicolas Gikakis (by invitation), Theodore E Maione, PhD* (by invitation), Maria Anna Kowalska, PhD** (by invitation), Zhanging Yan, MD, PhD** (by invitation), Stefan Niewiarowski, MD, PhD** (by invitation), L.Henry Edmunds, MD The Journal of Thoracic and Cardiovascular Surgery Volume 109, Issue 4, Pages 765-771 (April 1995) DOI: 10.1016/S0022-5223(95)70359-4 Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 1 Clotting time titration curves (partial thromboplastin times) after reversal of heparin anticoagulation in vitro (A) or heparinized baboon blood ex vivo (B). A, Protamine or rPF4 was added in the doses indicated to citrated baboon plasma containing a heparin concentration of 0.6 units/ml. B, A heparin dose of 300 units/kg body weight was injected intravenously into a baboon; five minutes later blood was drawn into citrate and neutralized with indicated doses of each drug. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 765-771DOI: (10.1016/S0022-5223(95)70359-4) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 1 Clotting time titration curves (partial thromboplastin times) after reversal of heparin anticoagulation in vitro (A) or heparinized baboon blood ex vivo (B). A, Protamine or rPF4 was added in the doses indicated to citrated baboon plasma containing a heparin concentration of 0.6 units/ml. B, A heparin dose of 300 units/kg body weight was injected intravenously into a baboon; five minutes later blood was drawn into citrate and neutralized with indicated doses of each drug. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 765-771DOI: (10.1016/S0022-5223(95)70359-4) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 2 In vitro calcium mobilization study for baboon and human neutrophils. Recombinant human neutrophil activating peptide 2 (NAP2) (Repligen Corp.) has potent neutrophil activating properties 15,17 and served as a control. rPF4 significantly increases baboon neutrophil calcium, but does not change human neutrophil calcium. rNAP-2 dramatically increases leukocyte calcium in both species. Open bars, Baboon neutrophils; shaded bars, human neutrophils. Values are mean ± standard error. *p < 0.05 between protamine and rPF4. **p < 0.05 within groups as compared with control values. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 765-771DOI: (10.1016/S0022-5223(95)70359-4) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 3 Thrombin times and partial thromboplastin times before and after heparin neutralization by protamine (solid bars) and rPF4 (lighter bars) after CPB in baboons. A, Thrombin times. B, Partial thromboplastin times. Statistics appear in Table I. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 765-771DOI: (10.1016/S0022-5223(95)70359-4) Copyright © 1995 Mosby, Inc. Terms and Conditions