An evidence-based standardized protocol for anticoagulation following congenital heart surgery

Catherine Deshaies, Nancy Poirier, Paul Khairy


Unfractionated heparin is the cornerstone of prevention and treatment of thrombosis in children undergoing cardiac surgery due to its short half-life and reversibility using protamine. Yet, optimal titration in children remains challenging (1). Age-related differences in heparin clearance (2), protein binding activity (3,4) and anti-thrombin concentration (5-8), which are most pronounced in neonates and young infants, obscure the applicability of standard adult dosing protocols.