Effects of protamine and heparin can be detected and easily differentiated by modified thrombelastography (Rotem®): an in vitro study

CT measurement using the Rotem® technique appears to be a valuable tool for heparin-protamine management. For detection of heparin alone, protamine alone and the two combined, the ratio of CT-INTEM:CT-HEPTEM can be used to distinguish the effects of heparin excess (CT-INTEM:CT-HEPTEM>1) from those of protamine excess (CT-INTEM:CT-HEPTEM=1).