Foster E D, Spector J I, Talarico L, Umlas J, Valeri C R, Dobnick D B, Berger R L
Ann Thorac Surg. 1977 Jun;23(6):514-9. doi: 10.1016/s0003-4975(10)63694-6.
Dose-response effects of heparin and protamine in 34 adult patients undergoing cardiac operations were monitored by an in vitro analysis utilizing hexadimetharine bromide (Polybrene) neutralization. Heparin administered prior to cannulation for cardiopulmonary bypass in a dose of 3.0 mg (300 units) per kilogram of body weight, and 1.5 mg (150 units) per kilogram for each subsequent hour of bypass, routinely produced circulating heparin concentrations greater than 1.0 units per milliliter of plasma. A protamine dose equal to 80% of the total number of milligrams of heparin given resulted in no detectable plasma heparin in 23 of the 34 patients one-half hour after administration. No patient required protamine in an amount greater than the total number of milligrams in the heparin dose to achieve heparin neutralization. Modest postoperative chest tube drainage (mean, 784 ml in 48 hours) in these patients provides clinical support for low-dose protamine administration for heparin neutralization at the conclusion of cardiopulmonary bypass.
采用溴化己二甲铵（鱼精蛋白）中和法进行体外分析，监测了34例接受心脏手术的成年患者中肝素和鱼精蛋白的剂量反应效应。在进行体外循环插管前，按每千克体重3.0毫克（300单位）的剂量给予肝素，在体外循环随后的每小时按每千克体重1.5毫克（150单位）给予，通常会使血浆中循环肝素浓度大于每毫升1.0单位。给予相当于所给肝素总毫克数80%的鱼精蛋白剂量后，34例患者中有23例在给药半小时后血浆中检测不到肝素。为实现肝素中和，没有患者所需的鱼精蛋白量超过肝素剂量的总毫克数。这些患者术后胸腔引流管引流量适中（48小时平均为784毫升），这为体外循环结束时采用低剂量鱼精蛋白进行肝素中和提供了临床支持。
