Bull B S, Korpman R A, Huse W M, Briggs B D
J Thorac Cardiovasc Surg. 1975 May;69(5):674-84.
Five heparin protocols, representative of about 30 presently used throughout the country, were analyzed. The adequacy of anticoagulation during and the precision of protamine neutralization at the conclusion of extracorporeal circulation were studied. In each of 50 patient's age, height, weight, or surface area was of no help in predicting heparin kinetics. The study group consisted of the 2 patients with the longest and the 2 patients with the shortest heparin half lives, as well as the 2 patients who showed the greatest sensitivity to heparin and the 2 who showed the least. By computer simulation, each was managed according to the five protocols and by a monitoring procedure. The protocols failed to provide safe anticoagulation or precise protamine neutralization, whereas the simplified monitoring approach was uniformly successful.
对全国目前使用的约30种肝素方案中的5种进行了分析。研究了体外循环期间抗凝的充分性以及体外循环结束时鱼精蛋白中和的精确性。在50名患者中，年龄、身高、体重或体表面积对预测肝素动力学均无帮助。研究组包括肝素半衰期最长的2名患者、最短的2名患者、对肝素敏感性最高的2名患者以及最低的2名患者。通过计算机模拟，按照这5种方案并采用一种监测程序对每名患者进行处理。这些方案未能提供安全的抗凝或精确的鱼精蛋白中和，而简化的监测方法则始终成功。
