Heparin therapy during extracorporeal circulation. II. The use of a dose-response curve to individualize heparin and protamine dosage.
Heparin therapy during extracorporeal circulation. II. The use of a dose-response curve to individualize heparin and protamine dosage.
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体外循环期间的肝素治疗。
DOI：
10.1016/s0022-5223(19)41500-6
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发表时间：
1975
期刊：
影响因子：
--
通讯作者：
Ralph A. Korpman
中科院分区：
文献类型：
--
作者：
Brian S. Bull;W. M. Huse;Floyd S. Brauer;Ralph A. Korpman
由于根据既定方案施用肝素和鱼精蛋白将无法安全抗凝或适当中和大量患者，因此提出了一种在体外循环期间监测肝素治疗的方法。可以从三个 ACT 中足够准确地确定将肝素剂量与其对活化凝血时间 (ACT) 的影响相关联的剂量反应曲线，以用于临床目的。制备这样的曲线使得可以在旁路期间将抗凝维持在安全范围内，并且最小化所需的凝血监测测试的数量。在旁路结束时，该曲线可用于预测中和所需的鱼精蛋白的精确量。摆脱了高肝素血症或鱼精蛋白过量的混乱影响，医生可以更容易地诊断和治疗术后出血问题。
Because the administration of heparin and protamine according to a set protocol will fail to anticoagulate safely or neutralize appropriately a significant number of patients, a method of monitoring heparin therapy during cardiopulmonary bypass is presented. A dose response curve relating heparin dosage to its effect on the activated coagulation time (ACT) can be determined with sufficient accuracy for clinical purposes from three ACT's. Preparation of such a curve makes it possible to maintain anticoagulation in a safe range during bypass and minimizes the number of monitoring tests of coagulation required. At the conclusion of bypass, this curve can be used to predict the precise amount of protamine needed for neutralization. Freed from the confusing effects of hyperheparinemia or protamine excess, the physician can diagnose and treat postoperative bleeding problems much more readily.