PMID- 23546721
OWN - NLM
STAT- MEDLINE
DCOM- 20130925
LR  - 20130402
IS  - 1940-6029 (Electronic)
IS  - 1064-3745 (Linking)
VI  - 992
DP  - 2013
TI  - Protamine titration.
PG  - 279-87
LID - 10.1007/978-1-62703-339-8_21 [doi]
AB  - Protamine titration is the gold standard method for the measurement of 
      unfractionated heparin (UFH) concentration in plasma. Protamine titration 
      produces reliable and reproducible results; however it is -generally not 
      considered a convenient assay for current clinical management of UFH as it is not 
      readily automated (Olson et al. Arch Pathol Lab Med 122(9):782-798, 1998). Early 
      clinical trials of UFH therapy determined that a heparin concentration of 0.2-0.4 
      U/ml by protamine titration correlated to an APTT of 1.5-2.5 times higher 
      compared to baseline values produced desirable UFH safety and efficacy outcomes 
      (Hull et al. N Engl J Med 315(18):1109-1114, 1986; Hull et al. N Engl J Med 
      322:1260-1264, 1990; Turpie et al. N Engl J Med 320:352-357, 1989; Brill-Edwards 
      et al. Ann Intern Med 119(2):104-109, 1993; Hull Int Angiol 14(1):32-34, 1995). 
      Such studies paved the way to the current view that it is no longer ideal to 
      manage UFH based solely upon a 1.5-2.5 times prolongation of the "normal" APTT. 
      Most advisory bodies recommend therapeutic APTTs be determined by correlating 
      APTT results with therapeutic UFH levels as measured by anti-Xa assay (0.35-0.7 
      U/ml) or protamine titration (0.2-0.4 U/ml) (Hirsh and Raschke. Chest 
      126(3):188S-203S, 2004) (see Note 1). The concentration of UFH in a sample is 
      measured by determining the amount of protamine required to return the thrombin 
      clotting time (TCT) test (prolonged by UFH) to a pre-UFH level (Laffan and 
      Manning. Dacie and Lewis: practical haematology. Churchill Livingstone: London, 
      2001).
FAU - Newall, Fiona
AU  - Newall F
AD  - Department of Clinical Haematology, The Royal Children's Hospital, Melbourne, 
      Australia.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Methods Mol Biol
JT  - Methods in molecular biology (Clifton, N.J.)
JID - 9214969
RN  - 0 (Protamines)
RN  - 9005-49-6 (Heparin)
RN  - EC 3.4.21.5 (Thrombin)
SB  - IM
MH  - Blood Coagulation
MH  - Blood Coagulation Tests/*methods
MH  - Heparin/*blood
MH  - Humans
MH  - Protamines/blood/*pharmacology
MH  - Thrombin/*metabolism
EDAT- 2013/04/03 06:00
MHDA- 2013/09/26 06:00
CRDT- 2013/04/03 06:00
PHST- 2013/04/03 06:00 [entrez]
PHST- 2013/04/03 06:00 [pubmed]
PHST- 2013/09/26 06:00 [medline]
AID - 10.1007/978-1-62703-339-8_21 [doi]
PST - ppublish
SO  - Methods Mol Biol. 2013;992:279-87. doi: 10.1007/978-1-62703-339-8_21.