[Verse 1] Three hundred units per kilo, grown folks get the dose, Kids climb to three-fifty, heavier the cost, Push it before the blade kisses the sternum's door, Watch the ACT climbing, chasing four hundred and more, We hunt four-eighty on the monitor's cold glow, Kaolin cartridge spinning secrets the plasma won't show, No clot dares to form while the heart's unplugged and still, Heparin's the bouncer guarding the clotting cascade's till. [Chorus] Heparin d'abord, mon coeur, avant de couper, Trois cents unités, le sang va se calmer, Protamine después, un miligramo por cien, Lento, slow, diez minutos — ça va bien, ACT au top or the pump refuses to start, Reverse it with care or you'll rattle the heart. [Verse 2] Sometimes the heparin shouts into silence, no reply, ACT stays stubborn, refractory and dry, Antithrombin's missing — the catalyst that binds, Heparin's just a key with no lock left to find, Reach for the concentrate, or plasma's quiet gift, Restore the cofactor, watch the numbers lift, Don't flood more heparin on a system running bare, Find the missing partner — that's the finesse of the chair. [Chorus] Heparin d'abord, mon coeur, avant de couper, Trois cents unités, le sang va se calmer, Protamine después, un miligramo por cien, Lento, slow, diez minutos — ça va bien. [Verse 3] Bypass closes, the cannulas retreat, Protamine enters, heparin's defeat, One milligram for every hundred units you gave, Titrate by response, let the dose-curve save, Push it slow, ten minutes, never rush the vein, Fast protamine invites a hypotensive rain, Too much protamine turns traitor on the clot, Impairs the platelets, coagulation shot — A paradox of plenty: the antidote turns foe, Measure twice, dose once, let the titration flow. [Verse 4] Type one is pressure dropping, vessels wide and lax, Histamine comes calling, just slow your stacks, Type two's anaphylaxis, the immune system's scream, Type three's the nightmare — lungs seizing mid-dream, A paroxysm grips the chest, sudden and severe, Cruel to a patched-up right ventricle, thin and spare, Call for inhaled nitric oxide, let the vessels sigh, Epinephrine standing ready, bypass standing by, Clamp back onto circuit if the lungs won't yield, Protamine's a gamble on an already fragile field. [Bridge] History of HIT, platelets turned against the plan, No heparin allowed within this patient's clan, Bivalirudin enters, a direct thrombin foe, No protamine to save you — so plan the circuit slow, Pas d'héparine ici, cuidado, mind the switch, One wrong drug on the pump and the whole plan hits a glitch. [Chorus] Heparin d'abord, mon coeur, avant de couper, Trois cents unités, le sang va se calmer, Protamine después, un miligramo por cien, Lento, slow, diez minutos — ça va bien, ACT au top or the pump don't start, Reverse it right, protect the fragile heart.
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