Key result
Intraaortic administration of protamine did not reduce the degree of systemic hypotension compared to intravenous administration, though the maximal pressure drop occurred slower (74.4 vs 61.7 seconds; p<0.05).
Why the study?
Does intraaortic administration of protamine reduce hemodynamic side effects compared to intravenous administration in men after cardiopulmonary bypass?
Does intraaortic administration of protamine reduce hemodynamic side effects compared to intravenous administration in men after cardiopulmonary bypass?
Absolute Event Rate: 74.4% vs 61.7%
p-value: p=<0.05
Intraaortic administration of protamine does not prevent systemic hypotension compared to intravenous administration, though intravenous administration causes more rapid and pronounced pulmonary circulatory changes.
Intraaortic protamine does not lessen post-bypass hypotension versus intravenous; leaves open differential pulmonary effects for prospective trials.
A hemodynamic study of men undergoing elective coronary artery bypass surgery was undertaken to elucidate the side effects of protamine given into the ascending aorta (group A, n = 16) or into the central venous line (group V, n = 16). After termination of extracorporeal circulation, protamine was infused over 120 seconds, and the hemodynamic profile was continuously recorded. During the first minute, the systemic arterial pressure fell to about 60% of the preprotamine level in both groups, but the hemodynamic changes occurred more rapidly (p < 0.05) in group V than in group A, with maximal pressure drop at 61.7 +/- 2.7 vs 74.4 +/- 4.9 seconds. Following spontaneous restoration of the systemic blood pressure, the pulmonary artery pressure rose considerably in both groups, as did the pulmonary capillary wedge and central venous pressures, reaching higher levels in the intravenous group. The cardiovascular responses were again more rapid in group V than in group A (p = 0.004). The degree of systemic hypotension thus did not benefit from use of the intraaortic rather than the intravenous route for administering protamine. The more pronounced and more rapid pulmonary circulatory changes in the intravenous group suggest that the hemodynamic effects of protamine are initiated in the lungs.
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Øvrum et al. (1992) studied Elective coronary artery bypass surgery (n=32). Intraaortic protamine administration vs. Intravenous protamine administration was evaluated on Time to maximal systemic arterial pressure drop (p=<0.05). Intraaortic administration of protamine did not reduce the degree of systemic hypotension compared to intravenous administration, though the maximal pressure drop occurred slower (74.4 vs 61.7 seconds; p<0.05).
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