ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hendry, P. J.
Right arrow Articles by Keon, W. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hendry, P. J.
Right arrow Articles by Keon, W. J.

The Annals of Thoracic Surgery, Vol 44, 263-268, Copyright © 1987 by The Society of Thoracic Surgeons

ARTICLES

The myocardial contractile responses to protamine sulfate and heparin

PJ Hendry, GC Taichman and WJ Keon

The administration of protamine sulfate for the reversal of heparin anticoagulation has been associated with adverse hemodynamic changes including hypotension and decreased cardiac output. The possible direct toxic effect of protamine on human right atrial trabeculae contracting isometrically in vitro was studied. Muscles were stimulated to contract at 1 Hz in Tyrode's solution (maintained at 34 degrees C, pH 7.4) into which protamine was continuously added. Following a polynomial regression analysis, a parabolic dose-response curve resulted. The equation was: y = 95.13 + 38.76x - 278.71x2 where y = relative developed force and x = concentration of protamine (milligrams per milliliters) (r = 0.82). The estimated concentration of protamine resulting in 50% developed force was 0.48 mg/ml. In a second series of experiments, protamine was added to the bath along with a neutralizing amount of heparin. This resulted in a limited reduction in the fall of relative developed force. Thus, protamine in high concentrations alone or in complex with heparin has a direct toxic effect on human myocardial muscle mechanics, and care is warranted in its clinical use.


This article has been cited by other articles:


Home page
 Anesth. Analg.Home page
E. Hochhauser, P. Halpern, V. Zolotarsky, T. Krasnov, J. Sulkes, and B. Vidne
Isoflurane and Sodium Nitroprusside Reduce the Depressant Effects of Protamine Sulfate on Isolated Ischemic Rat Hearts
Anesth. Analg., April 1, 1999; 88(4): 710 - 710.
[Abstract] [Full Text] [PDF]

Home page
 PerfusionHome page
A. Belboul and N. Al-Khaja
The effect of protamine on the epicardial microflow and the graft flow in open-heart surgery
Perfusion, March 1, 1997; 12(2): 99 - 106.
[Abstract] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. Oe, T. Asou, S. Morita, H. Yasui, and K. Tokunaga
PROTAMINE-INDUCED HYPOTENSION IN HEART OPERATIONS: APPLICATION OF THE CONCEPT OF VENTRICULAR-ARTERIAL COUPLING
J. Thorac. Cardiovasc. Surg., August 1, 1996; 112(2): 462 - 471.
[Abstract] [Full Text]

Home page
 CirculationHome page
R. B. Hird, T. W. Wakefield, R. Mukherjee, B. U. Jones, F. A. Crawford, P. C. Andrews, J. C. Stanley, and F. G. Spinale
Direct Effects of Protamine Sulfate on Myocyte Contractile Processes : Cellular and Molecular Mechanisms
Circulation, November 1, 1995; 92(9): 433 - 446.
[Abstract] [Full Text]

Home page
 PerfusionHome page
C. Aren
Review article : Heparin and protamine during cardiac surgery
Perfusion, July 1, 1989; 4(3): 171 - 181.
[PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 1987 by The Society of Thoracic Surgeons.