Document Detail

Systemic and pulmonary circulatory effects of protamine following cardiopulmonary bypass in man.
MedLine Citation:
PMID:  2063149     Owner:  NLM     Status:  MEDLINE    
The cardiovascular effects of protamine were studied in 19 men with normal left ventricular function undergoing primary myocardial revascularization. Protamine was given over 120 sec after termination of cardiopulmonary bypass. Arterial and pulmonary pressures, aortic blood flow, central venous pressure, heart rate and electrocardiogram were continuously registered. Pulmonary capillary wedge pressure was recorded at the times of maximal hemodynamic response. The systolic arterial pressure fell from 116 to 66 mmHg about 60 sec after the start of protamine infusion, but spontaneously began to rise after a few seconds, reaching 90% of pre-protamine levels at 126 sec. No inotropic drugs or volume infusion were given. At about 2 min, the mean pulmonary artery pressure rose from 16.3 to 26.2 mmHg and the central venous pressure from 7.0 to 11.4 mmHg. The heart rate and cardiac output were almost unchanged throughout. Systemic hypotension and pulmonary hypertension are suggested to represent true side effects of protamine or protamine/heparin complex. When left ventricular function is good, the hypotension reverses without treatment. Volume infusion may indeed precipitate right heart failure when the pre-load effect is added to the subsequent protamine-induced pulmonary hypertension.
E Ovrum; H Lindberg; E A Holen; M Abdelnoor; J Bech
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian journal of thoracic and cardiovascular surgery     Volume:  25     ISSN:  0036-5580     ISO Abbreviation:  Scand J Thorac Cardiovasc Surg     Publication Date:  1991  
Date Detail:
Created Date:  1991-08-08     Completed Date:  1991-08-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0121343     Medline TA:  Scand J Thorac Cardiovasc Surg     Country:  SWEDEN    
Other Details:
Languages:  eng     Pagination:  19-24     Citation Subset:  IM    
Department of Surgery A, National Hospital, Oslo, Norway.
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MeSH Terms
Cardiopulmonary Bypass*
Hemodynamics / drug effects*
Hypertension, Pulmonary / chemically induced
Hypotension / chemically induced
Infusions, Parenteral
Middle Aged
Protamines / adverse effects,  pharmacology*
Pulmonary Circulation / drug effects*
Pulmonary Wedge Pressure / drug effects
Reg. No./Substance:

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