Termination of the IV infusion generally will terminate the anticoagulant effect.
If immediate reversal is required protamine sulfate will result in neutralization of heparin. The dose of protamine is based on the amount of heparin administered in the previous 2 hours using Table 2.
Table 2-Protamine sulfate for immediate reversal
| Time since last heparin dose
|| Protamine dose/100 units heparin given
Maximum Protamine dose is 50 mg.
Protamine should be given IV over 10 minutes. Infusion rate should not exceed 5 mg/min. More rapid infusion may result in hypotension. Patients with hypersensitivity to fish and those who have received protamine-containing insulin or previous protamine therapy may be at risk of hypersensitivity reactions.
Obtain blood for an PTT and PT 15 minutes after the administration of protamine.
Excessive Protamine doses may worsen bleeding potential.
David, M., et al. Heparin and LMWH in Children. Thrombosis Interest Group of Canada. January 2007. http://www.tigc.org/eguidelines/heparinchild07.htm. Accessed 11/15/08.
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