Protamine sulfate for the reversal of enoxaparin associated hemorrhage beyond 12 h

Am J Emerg Med. 2019 Jan;37(1):174.e5-174.e6. doi: 10.1016/j.ajem.2018.09.043. Epub 2018 Sep 26.

Abstract

Clinical practice guidelines recommend protamine sulfate for reversal of enoxaparin associated bleeds dependent on the time from last administration and dose of enoxaparin. We present a case of a hemodynamically unstable patient with an enoxaparin induced abdominal wall hematoma/hemorrhage and the previous enoxaparin administration 21.5 h prior to presentation with a therapeutic anti-Xa assay (0.8 IU/mL) upon assessment in the emergency department. Along with resuscitative efforts, an interdisciplinary team collaborated to administer protamine sulfate 50 mg intravenous once (0.5 mg per 1 mg of enoxaparin) to reverse the therapeutic anticoagulation. Our case demonstrates the importance of monitoring renal function and the potential for accumulation of enoxaparin in patients with renal dysfunction leading to prolonged therapeutic anti-Xa assays. With the availability of anti-Xa assays, future reversal recommendations of enoxaparin associated bleeds using protamine sulfate should include the initial anti-Xa assay as a guide for the dosing regimen.

Keywords: Enoxaparin; Pharmacology; Protamine sulfate; Resuscitation; Toxicology.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Wall / diagnostic imaging
  • Aged
  • Anticoagulants / adverse effects*
  • Drug Administration Schedule
  • Emergency Service, Hospital
  • Enoxaparin / adverse effects*
  • Female
  • Hematoma / chemically induced*
  • Hematoma / complications
  • Hematoma / diagnostic imaging
  • Hematoma / drug therapy*
  • Heparin Antagonists / therapeutic use*
  • Humans
  • Protamines / therapeutic use*
  • Renal Insufficiency, Chronic / complications
  • Time Factors
  • Tomography, X-Ray Computed

Substances

  • Anticoagulants
  • Enoxaparin
  • Heparin Antagonists
  • Protamines