Study on the dosage of protamine used in acidic environment after cardiopulmonary bypass in patients with congenital heart disease
10.3760/cma.j.issn.1008-1372.2012.06.010
- VernacularTitle:酸性环境对先天性心脏病患儿体外循环术后鱼精蛋白中和作用的影响
- Author:
Miao GUO
;
Gang CHEN
;
Chengguang HE
;
Bing JIA
- Publication Type:Journal Article
- Keywords:
Heart defects,congenital/surgery/physiopathology;
Extracorporeal circulation;
Protamines/pharmacology;
Heparin/pharmacology
- From:
Journal of Chinese Physician
2012;14(6):753-755
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the dosage of protamine to counteract heparin in patients with different pH values of after - surgery plasma of congenital heart defect.MethodsThe clinical data of 108 patients during March 2011 to April 2011 with congenital heart diseases who underwent cardiopulmonary bypass(CPB) surgery were reviewed.The volumes of chest tube drainage were analyzed to investigate the dosage of protamine in patients with different pH values in plasma.ResultsThe dosages of protamine and the volumes of chest tube drainage[ ( 136.8 ± 22.8 ) ml] in patients with an acidic environmental plasma were higher than the patients in another group [ ( 112.6 ± 22.7 ) ml ] ( P＜ 0.01 ).In patients with non-acidic environments,the mean ratio of dosage of protamine to heparin was 1.23:1 ; meanwhile in patients with pH＜7.30 or base excess (BE) ＜ -6,the mean ratio was 1.86:1.It suggested the dosage of protamine increased significantly in patients with an acidic environmental plasma.ConclusionsDifferent plasma pH values could change the dosage of protamine after cardiopulmonary bypass,and the acidic environment would increase the dosage of protamine and increase the volume of chest tube drainage after surgery.When pH ＜ 7.30 or BE ＜ - 6 at the end of CPB,to correct acid-base balance first and then calculate the dose of protamine was recommended.
