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**Heparin** is an animal-derived, heterogeneous sulfated glycosaminoglycan anticoagulant used to prevent clot formation during cardiopulmonary bypass and other extracorporeal-circulation procedures. It binds and potentiates antithrombin, accelerating inhibition of coagulation factor Xa and thrombin, thereby suppressing fibrin formation. In the Phase 4 SANE-sponsored cardiac-surgery study, intravenous heparin administration was compared using fixed-dose versus individualized titration protocols, alongside different protamine reversal approaches, to evaluate postoperative bleeding and transfusion requirements.
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