Cannulation Strategies in Adult Veno-arterial and Veno-venous Extracorporeal Membrane Oxygenation: Techniques, Limitations, and Special Considerations

Despite the study limitations, the authors found that protamine administration through radial artery route can effectively neutralize heparin without any significant coagulopathy and postoperative bleeding. We suggest using this derived low dose of protamine (total heparin dose/1.6) through radial arterial route can be practical and efficient to reverse the effect of heparin after cardiac surgery without using central route (ascending aorta or central venous line).