title: Haemodynamic effects of heparin during coronary bypass surgery.
abstract: Heparin has been suggested as an activator of the plasma kallikrein-kinin system, with possible formation of bradykinin, a potent vasodilator. Haemodynamic effects and changes in the kallikrein-kinin system were studied after heparin- and saline-injections in ten patients undergoing coronary bypass surgery. A moderate decrease in mean arterial pressure was found in all patients in the observation period, but significantly more at 2 and 3 min after heparin-injection compared with saline-injection. None of the other haemodynamic variables measured were significantly different when comparing heparin- to saline-injection. Heparin-injection resulted in significant changes in the kallikrein-kinin system, with a marked increase in spontaneous kallikrein-like activity as the most prominent feature, while no changes were found after saline-injection. Liberation of bradykinin would be expected to give a decrease in systemic vascular resistance with an increase in cardiac output. The results indicate that the plasma kallikrein-kinin system, though apparently activated after heparin-injection, does not contribute significantly to the decrease in arterial pressure in the patients studied.
authors.affiliation: Department of Anaesthesiology, Rikshospitalet, Oslo, Norway.
authors.forename: U E
authors.initials: UE
authors.lastname: Kongsgaard
authors.forename: N
authors.initials: N
authors.lastname: Smith-Erichsen
authors.forename: E
authors.initials: E
authors.lastname: Hysing
authors.forename: S
authors.initials: S
authors.lastname: Tølløfsrud
authors.forename: E
authors.initials: E
authors.lastname: Seem
authors.forename: O
authors.initials: O
authors.lastname: Geiran
authors.forename: L
authors.initials: L
authors.lastname: Bjørnskau
mesh_terms: D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D001026:Coronary Artery Bypass; D004311:Double-Blind Method; D005112:Extracorporeal Circulation; D006439:Hemodynamics / Q000187:drug effects; D006493:Heparin / Q000494:pharmacology*; D006801:Humans; D016234:Kallikrein-Kinin System / Q000187:drug effects*; D007610:Kallikreins / Q000037:antagonists & inhibitors / Q000097:blood; D011288:Prekallikrein / Q000032:analysis; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D006493:Heparin; D011288:Prekallikrein; D007610:Kallikreins