Sun21November1151AM 2

Are the following statements true or false regarding protamine sulphate?

True / False

It is effective at reversing the effects of unfractionated heparin Correct

It should be given if there is extensive bleeding during cardiopulmonary bypass Incorrect answer selected

Is a small, non-polar molecule Correct

It activates antithrombin III Correct

Can cause cardiovascular collapse if given rapidly Incorrect answer selected

Explanation

Protamine is a specific antidote to unfractionated heparin. It is a small basic positively charged protein (approximately 5.1 kDa in size) that was originally produced from salmon sperm. It binds to and inactivates heparin and therefore if it is given during cardiopulmonary bypass it will cause clotting in the bypass machine, which will deprive the patient of all blood flow and oxygenation.

It can cause a number of adverse effects, namely

Increased pulmonary artery pressure

Cardiovascular collapse and

Bronchospasm

all of which are more common if it is given into a central vein, or administered rapidly.

Therefore, protamine should not be administered while the patient depends on cardiopulmonary bypass.

It should be given slowly, ideally via a large-bore peripheral cannula.

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Average score: 77.54%

Times answered: 244