Sethna D H, Moffitt E, Gray R J, Bussell J, Raymond M, Conklin C, Matloff J M
Anesth Analg. 1982 Mar;61(3):247-51.
The effect of protamine sulfate on myocardial oxygen supply and demand was studied under clinical conditions in nine patients following cardiopulmonary bypass. Before surgery, the patients had severe coronary artery disease with good ventricular function. The patients required no vasoactive drugs, but only blood volume adjustments when weaned off bypass, and were hemodynamically stable at the time of study. The protamine dose of 196 mg (2.5 mg/kg) was infused over 4 +/- 1 minutes. Although modest variation in hemodynamic function occurred in individual patients after administration of protamine, there were no significant hemodynamic alterations for the group. No significant alteration in global myocardial metabolism was observed. Protamine caused a small decrease in measured coronary blood flow, resulting in a corresponding reduction in calculated myocardial oxygen consumption as coronary sinus oxygen content remained unaltered. Myocardial lactate extraction showed no significant alteration. It is concluded that protamine sulfate, given at rapid infusion rates in hemodynamically stable patients, is not associated with an adverse alteration in hemodynamics or global myocardial metabolism.
在临床条件下，对9例体外循环术后患者研究了硫酸鱼精蛋白对心肌供氧量和需氧量的影响。术前，这些患者患有严重冠状动脉疾病，但心室功能良好。患者不需要血管活性药物，仅在脱离体外循环时需要调整血容量，且在研究时血流动力学稳定。将196 mg（2.5 mg/kg）的鱼精蛋白剂量在4±1分钟内输注完毕。尽管给予鱼精蛋白后个别患者的血流动力学功能有适度变化，但该组患者并无显著的血流动力学改变。未观察到整体心肌代谢有显著变化。鱼精蛋白使测量的冠状动脉血流量略有减少，由于冠状窦氧含量保持不变，导致计算出的心肌耗氧量相应降低。心肌乳酸摄取无显著变化。得出的结论是，在血流动力学稳定的患者中快速输注硫酸鱼精蛋白，不会引起血流动力学或整体心肌代谢的不良改变。
