PMID: 2098007Sep 1, 1990Paper

Adverse cardiopulmonary effects and increased plasma thromboxane concentrations following the neutralization of heparin with protamine in awake sheep are infusion rate-dependent

Anesthesiology
D R MorelJ F Pittet

Abstract

The effect of the rate of intravenous infusion of protamine on the acute hemodynamic and pulmonary effects of heparin neutralization was investigated in six adult sheep surgically instrumented for chronic studies. Bovine lung heparin at a dose of 200 IU/kg was injected intravenously over 10 sec, 5 min before the start of protamine administration. On separate experimental days, each sheep received protamine at the same dose of 2 mg/kg, but it was infused over four different time periods: 3 s, 30 s, 300 s, or 30 min. At an additional session, protamine was administered over 3 s without prior heparinization to assess the effect of protamine alone. The sequence of the sessions was randomized and performed blindly. Injecting protamine in unheparinized sheep produced no change in any of the measured variables. In contrast, when protamine was injected over 3 s in heparinized sheep, it induced a transient and significant (P less than 0.001) pulmonary hypertension (from 17.2 +/- 1.5 to 45.6 +/- 2.4 mmHg at 1 min) with an increased pulmonary (five-fold) and systemic (2.5-fold) vascular resistance; a decrease of cardiac output (from 3.85 +/- 0.43 to 1.93 +/- 0.29 l/min) without change in left atrial pressure (from 5.3 +/- 1.3 to 6.0 +/- 1...Continue Reading

Citations

Jun 19, 2004·International Anesthesiology Clinics·Kyung W Park
Aug 1, 1993·British Journal of Pharmacology·T AkataS Takahashi
Jul 1, 1995·Anesthesia and Analgesia·T S HakimE M Camporesi
Oct 1, 1995·Anesthesiology·T HoriguchiM Suzuki
Mar 8, 2016·Journal of Cardiothoracic and Vascular Anesthesia·Mark A ChaneyValuvan Jeevanandam
Oct 7, 2006·Journal of Cardiothoracic and Vascular Anesthesia·Hadi Sakhai, Alfonso Casta
Aug 1, 1995·Journal of Cardiothoracic and Vascular Anesthesia·U Jain
Jul 3, 2020·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Adam B EdwardsBruno P Meloni
Oct 12, 2020·The Journal of Allergy and Clinical Immunology. in Practice·Ana Dioun BroylesMariana Castells

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