Kesteven P J, Ahmed A, Aps C, Williams B T, Savidge G F
J Cardiovasc Surg (Torino). 1986 Sep-Oct;27(5):600-3.
The efficacy of heparin reversal was investigated in 35 patients undergoing open-heart surgery. A total protamine sulphate dose of 3.0 mgs/kg was administered in divided doses and given as a continuous infusion. On this regime complete heparin neutralisation was observed 10 min after decannulation, but heparin levels were again detectable in 29% of cases 2 hours later. This phenomenon was found to correlate with the total circulating load of heparin to be neutralised. All cases with detectable postoperative heparin levels had in-vivo protamine sulphate: heparin ratios of less than 1.6. These data suggest that in-vitro assays of protamine sulphate neutralisation of heparin may seriously underestimate the required dose of protamine sulphate following open-heart surgery.
对35例接受心脏直视手术的患者进行了肝素逆转疗效的研究。硫酸鱼精蛋白总剂量为3.0毫克/千克，分剂量给药并持续输注。按照该方案，在拔除插管后10分钟观察到肝素完全中和，但2小时后，29%的病例中再次检测到肝素水平。发现这种现象与待中和的肝素总循环负荷相关。所有术后肝素水平可检测到的病例，体内硫酸鱼精蛋白与肝素的比例均小于1.6。这些数据表明，体外硫酸鱼精蛋白中和肝素的试验可能会严重低估心脏直视手术后所需的硫酸鱼精蛋白剂量。
