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Ann Thorac Surg 1983;35:637-642
© 1983 The Society of Thoracic Surgeons

Articles

Hemodynamic Effects of Intraaortic Administration of Protamine

Alfredo L. Pauca, M.D.*, Joseph E. Graham, M.D., Allen S. Hudspeth, M.D.

From the Departments of Anesthesia and Surgery, The Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC

Accepted for publication July 23, 1982.

* Address reprint requests to Dr. Pauca, Department of Anesthesia, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27103


   Abstract
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 Abstract
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Seventy-nine consecutive patients were given protamine rapidly into the ascending aorta during neutralization of heparin at the end of cardiopulmonary bypass. Simultaneously left atrial, diastolic pulmonary arterial, or right atrial pressures were maintained constant by appropriate infusion of oxygenated blood into the aorta. The systemic and pulmonary vascular resistances did not change, mean arterial blood pressure increased slightly, and cardiac output increased significantly (p < 0.001). It seems that this method of heparin neutralization is safe provided that the intravascular volume can be maintained constant.


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  1. Gourin A, Streisand RL, Stuckey JH. Total cardiopulmonary bypass, myocardial contractility, and the administration of protamine sulfate J Thorac Cardiovasc Surg 1971;61:160.[Medline]
  2. Jacques MA. Protamine: antagonist to heparin Can Med Assoc J 1973;108:1291.[Medline]
  3. Conahan III TJ, Andrews RW, MacVaugh H. Cardiovascular effects of protamine sulfate in man Anesth Analg (Cleve) 1981;60:33.[Abstract/Free Full Text]
  4. Aris A, Solanes H, Bonnin JO, et al. Intraaortic administration of protamine: method for heparin neutralization after cardiopulmonary bypass Cardiovasc Dis (Bull Tex Heart Inst) 1981;8:23.
  5. Jobes DR, Schwartz AJ, Ellison N, et al. Monitoring heparin anticoagulation and its neutralization Ann Thorac Surg 1981;31:161.[Abstract/Free Full Text]
  6. Nadas AS, Fyler DC. Cardiac catheterizationIn: Nadas AS, Fyler DC, editors. Pediatric Cardiology. Philadelphia: Saunders; 1972. pp. 109-137.
  7. Jastrzebski J, Sykes MK, Woods DG. Cardiorespiratory effects of protamine after cardiopulmonary bypass in man Thorax 1974;29:534.[Abstract/Free Full Text]
  8. Jaques L, Mahadoo J. Pharmacodynamics and clinical effectiveness of heparin Semin Thromb Hemostas 1978;4:298.[Medline]



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