Biomaterial Database

The hemodynamic effects of intra-aortic versus intravenous administration of protamine for reversal of heparin in pigs. 1983

K Rogers, and B Milne, and T A Salerno

The hemodynamic effects of intra-aortic (IA) versus intravenous (IV) administration of protamine for reversal of heparin were studied in pigs. The animals were anesthetized with sodium thiopental, nitrous oxide, oxygen, and halothane. Twenty minutes after heparinization (3 mg/kg) the following hemodynamic parameters were measured: heart rate, arterial pressure, pulmonary artery pressure (PAP), left ventricular end-diastolic pressure, and cardiac output. Protamine sulfate (3 mg/kg) was injected over 30 seconds IV in Group I (five pigs) and into the ascending aorta (IA) in Group II (five pigs). After injection, the above measurements were repeated at 1.0, 2.5, 5, and 15 minutes. The hemodynamic effects of intravenous protamine (3 mg/kg) without prior heparinization were studied in Group III (four pigs). Groups I and II experienced a decrease in cardiac output (Group I, 14%; Group II, 29%) and a marked increase in PAP (Group I, 78%; Group II, 79%) and pulmonary vascular resistance (PVR) (Group I, 174%; Group II, 559%) which peaked at 1 minute after protamine injection (p less than 0.05). Cardiac output, PAP, and PVR returned to baseline within 15 minutes. Heart rate, arterial pressure, left ventricular end-diastolic pressure, and systemic vascular resistance (SVR) were unchanged. No hemodynamic abnormalities occurred in animals injected with protamine alone (Group III). It is concluded that IV or IA administration of protamine causes marked hemodynamic changes in heparinized pigs. This does not confirm a recent clinical study reporting stable hemodynamics after IA administration of protamine. The lack of circulatory effects of protamine in unheparinized pigs suggests that a protamine-heparin interaction may be involved.

UI	MeSH Term	Description	Entries
D007022	Hypotension	Abnormally low BLOOD PRESSURE that can result in inadequate blood flow to the brain and other vital organs. Common symptom is DIZZINESS but greater negative impacts on the body occur when there is prolonged depravation of oxygen and nutrients.	Blood Pressure, Low,Hypotension, Vascular,Low Blood Pressure,Vascular Hypotension
D007269	Injections, Intra-Arterial	Delivery of drugs into an artery.	Injections, Intraarterial,Intra-Arterial Injections,Intraarterial Injections,Injection, Intra-Arterial,Injection, Intraarterial,Injections, Intra Arterial,Intra Arterial Injections,Intra-Arterial Injection,Intraarterial Injection
D007275	Injections, Intravenous	Injections made into a vein for therapeutic or experimental purposes.	Intravenous Injections,Injection, Intravenous,Intravenous Injection
D011479	Protamines	A group of simple proteins that yield basic amino acids on hydrolysis and that occur combined with nucleic acid in the sperm of fish. Protamines contain very few kinds of amino acids. Protamine sulfate combines with heparin to form a stable inactive complex; it is used to neutralize the anticoagulant action of heparin in the treatment of heparin overdose. (From Merck Index, 11th ed; Martindale, The Extra Pharmacopoeia, 30th ed, p692)	Protamine,Protamine Sulfate,Protamine Chloride,Chloride, Protamine,Sulfate, Protamine
D006439	Hemodynamics	The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.	Hemodynamic
D006494	Heparin Antagonists	Coagulant substances inhibiting the anticoagulant action of heparin.	Antagonists, Heparin
D000818	Animals	Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA.	Animal,Metazoa,Animalia
D001011	Aorta	The main trunk of the systemic arteries.	Aortas
D013552	Swine	Any of various animals that constitute the family Suidae and comprise stout-bodied, short-legged omnivorous mammals with thick skin, usually covered with coarse bristles, a rather long mobile snout, and small tail. Included are the genera Babyrousa, Phacochoerus (wart hogs), and Sus, the latter containing the domestic pig (see SUS SCROFA).	Phacochoerus,Pigs,Suidae,Warthogs,Wart Hogs,Hog, Wart,Hogs, Wart,Wart Hog