Heparin has been shown to enhance ADP-induced platelet aggregation in patients undergoing cardiopulmonary bypass surgery. This effect appears to be maximal throughout the initial 30 minutes of systemic heparinization and once reached is maintained throughout the bypass procedure. The prebypass state is regained following heparin reversal by protamine sulphate. It is possible that this effect of heparin on platelet function may contribute towards some of the platelet microembolization phenomena seen in patients following cardiopulmonary bypass surgery.
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