The haemodynamic effects of intraaortic versus intravenous administration of protamine for reversal of heparin in man

Brian Milne, Kent Rogers, Frank Cervenko, Tomas Salerno

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

A recent report suggests that there may be advantages of intraaortic (IA) versus intravenous (IV) administration of protamine for reversal of heparin at the end of cardiopulmonary bypass. Because complete haemodynamic measurements were not performed in that study, we prospectively and randomly assessed the effects of protamine sulphate administered via either route. Patients were studied in the period immediately following cardiopulmonary bypass. Heparin, 300 units.Kg-1, plus 150 units.Kg-1 when required, was administered to keep the activated clotting time > 400 sec. Protamine 3 mg.Kg-1 was injected over 30 sec. intravenously in the IV group (n = 5) and into the ascending aorta in the IA group (n = 5). There was a significant decrease in arterial blood pressure (28.6 per cent) from 109.2 ±5.6 mmHg (S.E.) systolic to 78.0 ± 9.0 mmHg observed in the IA group one minute post protamine, which returned to baseline by 2.5 min (analysis of variance p < 0.05). No significant hypotension was observed in the IV group. There was no significant change in heart rate, left alrial pressure, central venous pressure, systemic vascular resistance or cardiac index with either IA or IV protamie. In contrast to our recent study in pigs there was no significant change in pulmonary artery pressure, pulmonary vascular resistance or cardiac output with protamine. Results indicate that there are no haemodynamic benefits of IA vs IV injection of protamine.

Original languageEnglish
Pages (from-to)347-351
Number of pages5
JournalCanadian Anaesthetists' Society Journal
Volume30
Issue number4
DOIs
StatePublished - Jul 1 1983
Externally publishedYes

Fingerprint

Protamines
Intravenous Administration
Heparin
Hemodynamics
Cardiopulmonary Bypass
Vascular Resistance
Pressure
Central Venous Pressure
Intravenous Injections
Cardiac Output
Hypotension
Pulmonary Artery
Aorta
Analysis of Variance
Arterial Pressure
Swine
Heart Rate

Keywords

  • blood coagulation: heparin, protamine
  • BLOOD pressure: drug effects

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

The haemodynamic effects of intraaortic versus intravenous administration of protamine for reversal of heparin in man. / Milne, Brian; Rogers, Kent; Cervenko, Frank; Salerno, Tomas.

In: Canadian Anaesthetists' Society Journal, Vol. 30, No. 4, 01.07.1983, p. 347-351.

Research output: Contribution to journalArticle

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