Heart & lung : the journal of critical care
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Adverse responses to protamine sulfate have been identified for many years. The antigen-antibody response to protamine sulfate results in a type I anaphylactic reaction. ⋯ Several potential risk factors for adverse reactions to protamine have been identified, including insulin-dependent diabetes mellitus, vasectomy, allergy to fish, prior exposure to protamine sulfate, and the rate of infusion. A case study is presented, and strategies for improving patient outcomes are discussed.