Suwanchinda V, Prakanrattana U
J Med Assoc Thai. 1989 Jun;72(6):303-6.
The hemodynamic effects of left atrial administration of protamine for heparin reversal were compared with the peripheral venous route. One hundred patients, undergoing cardiac surgery, using cardiopulmonary bypass (CPB) at Siriraj hospital were randomly allocated into two equal groups of fifty. The preoperative and operative characteristics of the two groups were comparable. After the termination of CPB, protamine sulfate was administered over 3 minutes via the left atrium in group I, and via the peripheral vein in group II. The hemodynamics were measured before and 5, 15 and 30 minutes after protamine administration. There were no statistically significant differences in heart rate (HR), arterial blood pressure (BP), and central venous pressure (CVP) between the groups. After administrating protamine and adequate maintaining the preload in both groups of patients within the normal range, the HR did not change from immediate post CBP control values. The arterial BP was not changed for 5 minutes, thereafter, significantly elevated toward the preoperative baseline values. This data indicates that the left atrial injection of protamine does not provide any hemodynamic advantages over the peripheral venous administration.
将经左心房注射鱼精蛋白以逆转肝素作用的血流动力学效应与经外周静脉注射的情况进行了比较。100例在诗里拉吉医院接受体外循环心脏手术的患者被随机分为两组，每组50例。两组患者的术前及手术特征具有可比性。体外循环结束后，在第一组中经由左心房在3分钟内注射硫酸鱼精蛋白，在第二组中经由外周静脉注射。在注射鱼精蛋白前以及注射后5分钟、15分钟和30分钟测量血流动力学指标。两组之间的心率（HR）、动脉血压（BP）和中心静脉压（CVP）无统计学显著差异。在两组患者中注射鱼精蛋白并将前负荷充分维持在正常范围内后，心率与体外循环刚结束时的对照值相比没有变化。动脉血压在5分钟内未改变，此后朝着术前基线值显著升高。该数据表明，与经外周静脉给药相比，经左心房注射鱼精蛋白在血流动力学方面并无任何优势。
