Velders A J, Wildevuur C R
Ann Thorac Surg. 1986 Aug;42(2):168-71. doi: 10.1016/s0003-4975(10)60512-7.
Protamine is given after cardiopulmonary bypass to reverse the effect of heparin. However, the adverse effects of an overdose have not been fully evaluated. In this canine study, a standard dose of one bolus of heparin (300 IU per kilogram of body weight) was neutralized by an infusion of protamine hydrochloride in a 1:2 ratio. Platelet number and function were severely reduced by this overdose of protamine, and this finding correlated with a prolongation of the bleeding time. Giving a titrated dose of protamine hydrochloride to reverse heparin activity, measured by the activated clotting time, affected neither platelet number nor function. When prostacyclin (0.5 microgram/kg/min) was infused during administration of an overdose of protamine, platelets again were not affected by the excess of protamine.
在体外循环后给予鱼精蛋白以逆转肝素的作用。然而，过量使用的不良反应尚未得到充分评估。在这项犬类研究中，以1:2的比例输注盐酸鱼精蛋白来中和一剂标准剂量的肝素（每千克体重300国际单位）。这种过量的鱼精蛋白严重降低了血小板数量和功能，这一发现与出血时间延长相关。给予滴定剂量的盐酸鱼精蛋白以逆转通过活化凝血时间测量的肝素活性，对血小板数量和功能均无影响。当在过量使用鱼精蛋白期间输注前列环素（0.5微克/千克/分钟）时，血小板同样不受过量鱼精蛋白的影响。
