Serious adverse reactions to protamine sulfate: Are alternatives needed?

摘要: Abstract Protamine sulfate is a strongly cationic polypeptide that used commonly in clinical medicine. It administered regularly after cardiac catheterization, cardiothoracic and vascular surgical procedures, less frequently dialysis leukapheresis 2–4 because of its capacity to reverse the anticoagulant activity heparin. 5, 6 In addition, it delays absorption insulin, protamine combined with insulin zinc neutral Hagedorn insulin. 7, 8 Recently, there have been reports adverse reactions 9, 20 (Table 1). Although most these were relatively mild, three fatal 21 ; one was clearly result type I anaphylaxis. Reactions occur predominantly patients who previously exposed through protamine-containing insulins or during heparin neutralization. Almost 50% diabetic; whom received thereby enhancing their chance for presensitization. 1983 we encountered suffered sulfate. Two will be presented here; third patient, died IgE-mediated anaphylaxis, has already reported therefore mentioned only briefly. We shall discuss alternatives routine use this drug.