This article reviews randomized controlled trials and prospective studies comparing individualized heparin and protamine dosing based on real-time blood heparin concentration versus traditional total body weight methods during cardiopulmonary bypass (CPB). Meta-analysis shows that individualized dosing significantly reduces postoperative blood loss, improves protamine-to-heparin ratios, and increases early postoperative platelet counts. These findings suggest that precision in heparin and protamine dosing could decrease bleeding and transfusion needs, highlighting the potential of machine learning for future advancements in anticoagulation management for CPB.