Hecht Patrick, Besser Martin, Falter Florian
Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver General Hospital, Vancouver, Canada.
Department of Haematology; and.
J Extra Corpor Technol. 2020 Mar;52(1):63-70. doi: 10.1182/ject-1900038.
Without anticoagulation, cardiopulmonary bypass would not have developed over the last nearly 60 years into one of the most influential innovations in medicine; without the ability to reverse anticoagulation, cardiac surgery might not have become the common intervention, which is now practiced globally. Despite the recent breathtaking developments in extracorporeal technology, heparin and protamine remain the pillars of anticoagulation and its reversal until this day. However, there is still much controversy in particular about protamine dosing regimens. A number of recent publications investigating various approaches to dosing protamine have rekindled this debate. This review is seeking to capture the current thinking about protamine dosing after cessation of cardiopulmonary bypass.
如果没有抗凝技术，体外循环在过去近60年里就不可能发展成为医学领域最具影响力的创新之一；如果没有逆转抗凝的能力，心脏手术可能就不会成为如今在全球广泛开展的常见干预手段。尽管近年来体外循环技术取得了惊人的进展，但直到今天，肝素和鱼精蛋白仍然是抗凝及其逆转的支柱。然而，特别是在鱼精蛋白给药方案方面仍存在诸多争议。最近一些研究鱼精蛋白不同给药方法的出版物重新引发了这场辩论。本综述旨在总结关于体外循环停止后鱼精蛋白给药的当前观点。
