Umlas J, Taff R H, Gauvin G, Swierk P
Anesth Analg. 1983 Dec;62(12):1095-9.
Confident monitoring of heparin during cardiopulmonary bypass and subsequent neutralization by protamine has been hampered by the absence of an accurate, reproducible, rapid, simple, and specific assay for heparin. By using two new instruments in tandem, one of which produced 0.5 ml of plasma in 1 min and one which specifically measures heparin in 3-4 min, heparin levels are available in approximately 5 min. By performing heparin assays at a variety of intervals, it was demonstrated that 76% of patients receiving common doses of heparin during cardiopulmonary bypass may have plasma levels that are potentially too low. Minimum neutralizing doses of protamine may be calculated using the formula: (estimated blood volume + pump prime volume) X (plasma heparin level/100) X 1.1 + 50. These doses were nearly two-thirds of previous doses and were unassociated with increased bleeding, clotting, or clinically significant heparin rebound.
由于缺乏一种准确、可重复、快速、简单且特异的肝素检测方法，在体外循环期间对肝素进行可靠监测以及随后用鱼精蛋白进行中和一直受到阻碍。通过串联使用两种新仪器，其中一种在1分钟内可产生0.5毫升血浆，另一种在3 - 4分钟内可特异性检测肝素，大约5分钟即可获得肝素水平。通过在不同间隔时间进行肝素检测，结果表明，在体外循环期间接受常规剂量肝素治疗的患者中有76%的血浆水平可能潜在过低。鱼精蛋白的最小中和剂量可使用以下公式计算：（估计血容量 + 泵预充量）×（血浆肝素水平/100）×1.1 + 50。这些剂量几乎是先前剂量的三分之二，且与出血增加、凝血或临床上显著的肝素反跳无关。
