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The effect of protamine sulfate on platelet function.
B Lindblad1, T W Wakefield, W M Whitehouse
1Department of Surgery, University of Michigan Medical School, Ann Arbor.
Scandinavian Journal of Thoracic and Cardiovascular Surgery
|January 1, 1988
Summary
Protamine sulfate, used to reverse heparin, can cause adverse effects. This study found protamine inhibits thrombin-induced platelet aggregation, suggesting platelets play a role in protamine
Area of Science:
- Cardiovascular Pharmacology
- Hematology
- Pharmacology
Background:
- Protamine sulfate is crucial for neutralizing heparin's anticoagulant effects.
- Adverse reactions to protamine sulfate include hypotension, pulmonary hypertension, thrombocytopenia, and leukopenia.
- The precise mechanism of protamine's adverse effects requires further investigation.
Purpose of the Study:
- To investigate the mechanism of protamine sulfate's adverse effects.
- To evaluate the interaction between protamine sulfate and platelets.
- To determine the role of platelets in protamine-induced hemodynamic changes.
Main Methods:
- Preparation of platelet-rich plasma (PRP) from canine and human blood samples.
- Assessment of platelet aggregation induced by adenosine diphosphate and thrombin.
- Induction of thrombocytopenia in splenectomized dogs followed by protamine administration.
- Monitoring of systemic and pulmonary arterial pressures.
Main Results:
- Protamine sulfate inhibited thrombin-induced platelet aggregation in both canine and human PRP (p < 0.05).
- Adenosine diphosphate-induced platelet aggregation remained unchanged.
- Protamine administration in thrombocytopenic dogs caused systemic hypotension but not pulmonary hypertension.
- Leukopenia preceded the development of further thrombocytopenia.
Conclusions:
- Protamine-platelet interactions inhibit thrombin-induced platelet aggregation.
- Platelets may contribute to pulmonary pressure changes during protamine reversal.
- Protamine-induced systemic hypotension is not mediated by platelets.