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Ann Thorac Surg 1986;42:22-26
© 1986 The Society of Thoracic Surgeons

Articles

Comparison of the Cardiovascular Effects of Intravenous and Intraaortic Protamine in the Conscious and Anesthetized Dog

Robert L. Taylor, M.D., William C. Little, M.D., Gregory L. Freeman, M.D., D. Mark Avery, M.D., Susan E. Norris, B.S., J. Kent Trinkle, M.D., Frederick L. Grover, M.D.*

From the Audie L. Murphy Veterans Administration Hospital and the University of Texas Health Science Center at San Antonio

* Address reprint requests to Dr. Grover, 7703 Floyd Curl Dr, San Antonio, TX 78284

Controversy exists as to whether intraaortic (IA) administration of protamine sulfate has less adverse effects than the intravenous (IV) route. The effect of protamine on contractility is not well established. Therefore, 9 dogs underwent chronic instrumentation to monitor aortic pressure (AP), left ventricular (LV) pressure, central venous pressure, cardiac index (CI), heart rate, stroke volume index (SVI), systemic vascular resistance index, and LV volume. The end-systolic LV pressure–volume relationship was used as a load-independent measure of contractility. Each dog was administered IV and IA protamine on separate occasions after pretreatment with heparin. Studies were performed with and without anesthesia. In the awake studies, analysis of variance showed greater decreases in mean AP (p < .03), CI (p < .05), and SVI (p < .02) with IA protamine infusion. In the anesthetized animals, there were no significant differences between IA and IV administration of protamine. Protamine did not decrease contractility in any group. We conclude that IA administration of protamine offers no advantage over IV administration in the dog. Protamine does not decrease contractility when given by either route.




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