From Turkey: Type II Aortic Dissection

Regardless of the protamine test dosage, there is no reliable way to predict how a patient’s ACT will respond to a protamine test dose. Clot formation and circuit integrity is at risk when pump suction devices are continuously in use during PTD administration. Therefore, we strongly recommend that the direct recovery of mediastinal shed blood into the pump circuit be discontinued before any amount of protamine is administered to the patient.