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Ann Thorac Surg 1990;50:303-305
© 1990 The Society of Thoracic Surgeons

Articles

Reversal of protamine-induced catastrophic pulmonary vasoconstriction by prostaglandin E1

Glenn J.R. Whitman, MD*,a,b,1, Douglas Martel, MDa,b, Michael Weiss, MDa,b, Aura Pochanapring, MDa,b, W.Michael See, MDa,b, Alan Hopeman, MDa,b, Alden H. Harken, MDa,b, Ira M. Dauber, MDa,b

a Departments of Surgery, Anesthesia, and Cardiology, University of Colorado, Denver, Colorado, USA
b Department of Medicine, University of Washington, Seattle, Washington, USA

Accepted for publication February 19, 1990.

* Address reprint requests to Dr Whitman, University of Colorado Health, 4200 E 9th Ave, Box C310, Denver, CO 80220.

A case of catastrophic pulmonary vasoconstriction occurring after cardiopulmonary bypass after protamine reversal of heparin treated successfully with intravenous prostaglandin E1 is reported. Systemic hypotension was counteracted by epinephrine given through the left atrium. Protamine-heparin reactions are reviewed and a pathophysiological mechanism for the beneficial effect seen with prostaglandin E1 is proposed.




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