Adequate Heparin-protamine Neutralization on using Blood Cardioplegic Solution during Extracorporeal Circulation

체외 순환시간의 경과에 따른 Heparin과 Protamine의 적정량에 관한 연구

The clinical experience with the activated clotting time[A.C.T.] for the control of heparin and protamine therapy during cardiopulmonary bypass in 40 patients between April, 1987 and September, 1987 is reviewed retrospectively. All of patients used with cold blood potassium cardioplegia for myocardial protection under standard cardiopulmonary bypass, priming and perfusate techniques respectively. This study was divided into 2 groups of patients followed by cardiopulmonary bypass time. Twenty patients, within 60 minutes of cardiopulmonary bypass time[group A] were compared with twenty patients, from 60 to 120 minutes of cardiopulmonary bypass time[group B]. Using blood cardioplegia for myocardial protection, Author observed wide variation of A.C.T. in individual response to initial heparinization[2mg /kg] and no requirement of additional heparin during cardiopulmonary bypass until 120 minutes. Total heparin amount during cardiopulmonary bypass was not related to body weight and body surface area in the both groups. After cardiopulmonary bypass, amounts of protamine for neutralization of heparin were more required in group B.