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Sinus node function and protamine sulfate.

J Alvarez1, L Alvarez, C Escudero

  • 1Service of Anesthesia, Hospital Santa Cruz y San Pablo, Barcelona, Spain.

Journal of Cardiothoracic Anesthesia
|February 1, 1989
PubMed
Summary
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Protamine sulfate (PS) decreased heart rate in dogs during extracorporeal circulation (ECC). However, PS did not consistently affect sinoatrial node function, with prolonged recovery times only observed during rapid rewarming.

Area of Science:

  • Cardiology
  • Anesthesiology
  • Cardiovascular Surgery

Background:

  • Protamine sulfate (PS) is used to reverse heparin anticoagulation during cardiopulmonary bypass.
  • Understanding PS effects on cardiac function is crucial for patient safety during extracorporeal circulation (ECC).

Purpose of the Study:

  • To investigate the impact of protamine sulfate (PS) on heart rate (HR) and sinoatrial node function in dogs undergoing ECC.
  • To assess PS effects under various ECC modalities.

Main Methods:

  • Dogs were anesthetized and subjected to different ECC modalities.
  • Heparin sodium and protamine sulfate (PS) were administered.
  • Sinoatrial node function was assessed via sinoatrial conduction time (SACT), absolute sinus node recovery time (SNRTa), and corrected sinus node recovery time (SNRTc).

Related Experiment Videos

  • Spontaneous heart rate (HR) was monitored.

    • Main Results:

    • Protamine sulfate (PS) administration resulted in a decreased heart rate (HR) across all ECC groups.
    • Protamine sulfate (PS) did not show a consistent correlation between HR changes and sinoatrial node conduction/recovery times.
    • Sinoatrial conduction time (SACT) increased in dogs subjected to ECC.
    • Absolute and corrected sinus node recovery times (SNRTa, SNRTc) were prolonged only in the group undergoing rapid rewarming.

    Conclusions:

    • Protamine sulfate (PS) causes a decrease in heart rate during ECC, irrespective of the ECC modality.
    • The effects of protamine sulfate (PS) on sinoatrial node function are complex and do not directly correlate with heart rate changes.
    • Sinoatrial node recovery times are particularly affected by rapid rewarming during ECC when protamine sulfate is administered.