Hemodynamic and morphologic alterations after experimental administration of protamine sulfate.
The hemodynamic, hematologic, and morphologic effects induced by protamine sulfate have been studied in 28 dogs divided into 6 groups. All of the groups were given heparin (3 mg/kg body weight) and Groups I, II, III, and IV were given protamine (5 mg/kg body weight). Group I (control group) was not subjected to extracorporeal circulation. The other groups had the following interventions: Group II, cardiopulmonary bypass without aortic clamp, hypothermia, or cardioplegia; Groups III and V, hypothermia of 25 degrees C, aortic clamping for 25 minutes, administration of cardioplegic solution, and slow rewarming; and Groups IV and VI, the same as Groups III and V, but with rapid rewarming. After injection of protamine sulfate, there was a decrease in mean arterial pressure due to peripheral vasodilation and an increase in the mean pulmonary pressure due to increased pulmonary vascular resistance; marked diminution of the number of circulating platelets aside from the extracorporeal circulation; a decrease in the contractility of both ventricles with augmented right ventricular work and decreased cardiac output; and right ventricular edema in Groups I, II, III, and IV. These alterations were most evident in Groups III and IV.
Alvarez
J
J
Experimental Surgery Laboratories, Clinica Puerta de Hierro, Madrid, Spain.
Alvarez
L
L
Escudero
C
C
Gilsanz
F
F
de Oya
S
S
Castillo-Olivares
J L
JL
D000818:Animals; D004285:Dogs; D004562:Electrocardiography; D005112:Extracorporeal Circulation; D006352:Heart Ventricles / Q000187:drug effects / Q000648:ultrastructure; D006439:Hemodynamics / Q000187:drug effects*; D006493:Heparin / Q000494:pharmacology; D008168:Lung / Q000187:drug effects / Q000502:physiology / Q000648:ultrastructure; D008854:Microscopy, Electron; D008991:Monitoring, Physiologic; D011479:Protamines / Q000494:pharmacology*; D016276:Ventricular Function
D011479:Protamines; D006493:Heparin