title: Platelet damage by protamine and the protective effect of prostacyclin: an experimental study in dogs.
abstract: Protamine is given after cardiopulmonary bypass to reverse the effect of heparin. However, the adverse effects of an overdose have not been fully evaluated. In this canine study, a standard dose of one bolus of heparin (300 IU per kilogram of body weight) was neutralized by an infusion of protamine hydrochloride in a 1:2 ratio. Platelet number and function were severely reduced by this overdose of protamine, and this finding correlated with a prolongation of the bleeding time. Giving a titrated dose of protamine hydrochloride to reverse heparin activity, measured by the activated clotting time, affected neither platelet number nor function. When prostacyclin (0.5 microgram/kg/min) was infused during administration of an overdose of protamine, platelets again were not affected by the excess of protamine.
mesh_terms: D000244:Adenosine Diphosphate / Q000494:pharmacology; D000818:Animals; D001760:Bleeding Time; D001780:Blood Coagulation Tests; D001792:Blood Platelets / Q000187:drug effects*; D001794:Blood Pressure / Q000187:drug effects; D002315:Cardiopulmonary Bypass; D004285:Dogs; D004305:Dose-Response Relationship, Drug; D011464:Epoprostenol / Q000494:pharmacology*; D006493:Heparin / Q000494:pharmacology; D010974:Platelet Aggregation / Q000187:drug effects; D010976:Platelet Count; D010979:Platelet Function Tests; D011479:Protamines / Q000008:administration & dosage / Q000009:adverse effects* / Q000037:antagonists & inhibitors
chemical_list: D011479:Protamines; D000244:Adenosine Diphosphate; D006493:Heparin; D011464:Epoprostenol