Mabry C D, Read R C, Thompson B W, Williams G D, White H J
Arch Surg. 1979 Feb;114(2):129-34. doi: 10.1001/archsurg.1979.01370260019002.
An investigation of the response of the activated clotting time to systemic heparinization during cardiopulmonary bypass and peripheral vascular surgery was prompted by the death from clotting of a patient with endocarditis while undergoing valve replacement. The activated clotting time during cardiopulmonary bypass was thereafter maintained at 300 to 400 seconds. Consumption of heparin sodium, derived from an individual dose-response curve, was 0.01 to 3.86 units/kg/min. There was no correlation between initial heparin resistance and the subsequent rate of consumption. Some patients undergoing peripheral vascular surgery required additional heparin after an initial standard dose of 8,000 units so as to maintain their activated clotting time at twice the control values. These data are discussed in relation to previous articles, and recommendations are made for adequate intraoperative heparinization.
一名心内膜炎患者在进行瓣膜置换手术时死于凝血，这促使人们对体外循环和外周血管手术期间活化凝血时间对全身肝素化的反应进行研究。此后，体外循环期间的活化凝血时间维持在300至400秒。根据个体剂量反应曲线得出的肝素钠消耗量为0.01至3.86单位/千克/分钟。初始肝素抵抗与随后的消耗率之间没有相关性。一些接受外周血管手术的患者在初始标准剂量8000单位肝素后需要额外的肝素，以将其活化凝血时间维持在对照值的两倍。本文结合以前的文章对这些数据进行了讨论，并就术中充分肝素化提出了建议。
