Life-Threatening Reactions to Intravenous Protamine

Jerrold H. Levy; M. C. Tobin; L. L. Thomas; Michael E. Weiss; Daniel Nyhan; Zhikang Peng; Jan C. Horrow; E. Lowenstein; Carol Hirshman; N. Franklin Adkinson

doi:10.1056/NEJM198912143212417

Life-Threatening Reactions to Intravenous Protamine

Jerrold H. Levy, M. C. Tobin, L. L. Thomas, Michael E. Weiss, Daniel Nyhan, Zhikang Peng, Jan C. Horrow, E. Lowenstein, Carol Hirshman, N. Franklin Adkinson

School of Medicine

Research output: Contribution to journal › Letter › peer-review

4 Scopus citations

Abstract

To the Editor: Weiss et al. (April 6 issue)¹ have made an important contribution by demonstrating the presence of IgE and IgG antibodies in patients with life-threatening protamine reactions after heparin reversal. However, they further suggest that screening of patients at high risk, such as those receiving insulin preparations containing protamine, may be of value. I question whether this approach is cost effective in view of the low incidence of protamine reactions. We have reported a 2 percent (1 of 50) incidence of protamine reactions in patients receiving neutral protamine Hagedorn insulin in our prospective study of 1551 cardiac-surgery patients,.

Original language	English (US)
Pages (from-to)	1684-1685
Number of pages	2
Journal	New England Journal of Medicine
Volume	321
Issue number	24
DOIs	https://doi.org/10.1056/NEJM198912143212417
State	Published - Dec 14 1989

ASJC Scopus subject areas

General Medicine

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title = "Life-Threatening Reactions to Intravenous Protamine",

abstract = "To the Editor: Weiss et al. (April 6 issue)1 have made an important contribution by demonstrating the presence of IgE and IgG antibodies in patients with life-threatening protamine reactions after heparin reversal. However, they further suggest that screening of patients at high risk, such as those receiving insulin preparations containing protamine, may be of value. I question whether this approach is cost effective in view of the low incidence of protamine reactions. We have reported a 2 percent (1 of 50) incidence of protamine reactions in patients receiving neutral protamine Hagedorn insulin in our prospective study of 1551 cardiac-surgery patients,.",

author = "Levy, {Jerrold H.} and Tobin, {M. C.} and Thomas, {L. L.} and Weiss, {Michael E.} and Daniel Nyhan and Zhikang Peng and Horrow, {Jan C.} and E. Lowenstein and Carol Hirshman and Adkinson, {N. Franklin}",

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AU - Levy, Jerrold H.

AU - Tobin, M. C.

AU - Thomas, L. L.

AU - Weiss, Michael E.

AU - Nyhan, Daniel

AU - Peng, Zhikang

AU - Horrow, Jan C.

AU - Lowenstein, E.

AU - Hirshman, Carol

AU - Adkinson, N. Franklin

PY - 1989/12/14

Y1 - 1989/12/14

N2 - To the Editor: Weiss et al. (April 6 issue)1 have made an important contribution by demonstrating the presence of IgE and IgG antibodies in patients with life-threatening protamine reactions after heparin reversal. However, they further suggest that screening of patients at high risk, such as those receiving insulin preparations containing protamine, may be of value. I question whether this approach is cost effective in view of the low incidence of protamine reactions. We have reported a 2 percent (1 of 50) incidence of protamine reactions in patients receiving neutral protamine Hagedorn insulin in our prospective study of 1551 cardiac-surgery patients,.

AB - To the Editor: Weiss et al. (April 6 issue)1 have made an important contribution by demonstrating the presence of IgE and IgG antibodies in patients with life-threatening protamine reactions after heparin reversal. However, they further suggest that screening of patients at high risk, such as those receiving insulin preparations containing protamine, may be of value. I question whether this approach is cost effective in view of the low incidence of protamine reactions. We have reported a 2 percent (1 of 50) incidence of protamine reactions in patients receiving neutral protamine Hagedorn insulin in our prospective study of 1551 cardiac-surgery patients,.

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Life-Threatening Reactions to Intravenous Protamine

Abstract

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