The beneficial effects of aminophylline administration on heparin reversal with protamine.
The aim of this study was to demonstrate the beneficial effects of aminophylline on protamine cardiotoxicity. Thirty-four patients were examined, 17 of whom received aminophylline 3 mg/kg before protamine administration, being the study group, while the other 17, being the control group, did not. All cardiac output and biochemical measurements were evaluated 5 min following protamine administration. The cAMP level was 43.4 +/- 3.51 pmol/ml in the study group and 18.7 +/- 2.98 in the control group (P < 0.0001) before protamine administration, while the oxygen extraction rate decreased from 49% to 44 +/- 2% in the control group, and from 51.2% to 47 +/- 3% in the study group (P < 0.03). The N-acetyl glucosaminidase value was 16.9 +/- 13.9 pmol/ml in the study group and 27.8 +/- 1.47 pmol/ml in the control group (P < 0.01), and myocardial lactate extraction was -0.20 +/- 0.03 in the control group and -0.07 +/- 0.07 in the study group (P < 0.001). The left ventricular stroke work index was 28.6 +/- 3.14 gm/m2 in the control group and 37 +/- 6.77 gm/m2 in the study group (P < 0.002). The findings of this study led us to conclude that the adverse effects of heparin neutralization using protamine can be relieved by aminophylline.
Katircioglu
S F
SF
Department of Cardiovascular Surgery, Türkiye Yüksek Ihtisas Hastanesi, Sihhiye, Ankara, Turkey.
Küçükaksu
D S
DS
Bozdayi
M
M
Dalva
K
K
Mavitaş
B
B
Zorlutuna
Y
Y
Taşdemir
O
O
Bayazit
K
K
D000118:Acetylglucosaminidase / Q000097:blood; D000328:Adult; D000628:Aminophylline / Q000008:administration & dosage* / Q000627:therapeutic use; D001026:Coronary Artery Bypass; D006321:Heart / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006493:Heparin / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D010101:Oxygen Consumption; D011300:Preoperative Care; D011479:Protamines / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use
D011479:Protamines; D000628:Aminophylline; D006493:Heparin; D000118:Acetylglucosaminidase