Key result
Cardiopulmonary bypass and heparin linked to a ~105% increase in free plasma propranolol fraction.
Why the study?
Does cardiopulmonary bypass with heparin and protamine alter the plasma binding of propranolol?
Population
7 patients undergoing cardiopulmonary bypass
Comparison
Cardiopulmonary bypass including administration… vs Baseline (prior to heparin administration)
Design
Cohort
Follow-up
3.1 hours post-bypass
Authors
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May warrant caution with propranolol dosing during bypass; leaves open clinical relevance for beta-blockade efficacy.
Observational (n=7)
Does cardiopulmonary bypass with heparin and protamine alter the plasma binding of propranolol?
Absolute Event Rate: 13.5% vs 6.6%
p-value: p=<0.001
Cardiopulmonary bypass with heparin administration significantly increases the free fraction of propranolol in plasma, likely due to changes in free fatty acid levels and hemodilution.
Wood et al. (1979) conducted an observational in Cardiopulmonary bypass (n=7). Cardiopulmonary bypass and heparin administration vs. Baseline (pre-heparin) was evaluated on Fraction of propranolol free in plasma (p=<0.001). Cardiopulmonary bypass and heparin administration doubled the free fraction of propranolol in plasma from 6.6% to 13.5% (P<0.001), which subsequently decreased after protamine administration.
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