Patients receive a high dose of heparin so that they don’t clot during cardiopulmonary bypass (CPB) surgery. These patients receive a drug protamine to reverse and neutralize the anticoagulant effects of heparin post-CPB. The quality of these clots post reversal are poor compared to normal highlighting that the dose of the reversal agent is critical.
Recently, Miles et al 2021 (Plos Medicine) used a mathematical model to guide protamine dosing and showed it improved thromboelastography r-time and reduced the dose administered relative to a fixed ratio.
Using Scanning electron microscopy, the group is able to assess blood clot quality and fibrin characteristics. This is an ongoing study with clinicians Daniel Aston and Florian Falter at Papworth Hospital Cambridge to assess clot quality.
Images were captured on a Zeiss Sigma 300 FEG-SEM in the Dunn School of Pathology, Electron Microscopy Facility. False colouring performed in Adobe Photoshop by Dr Samuel Bose.