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Protamine: does it alter right ventricular function?

R L Hines, P G Barash

    Anesthesia and Analgesia
    |December 1, 1986
    PubMed
    Summary
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    Protamine administration does not significantly impact right or left ventricular function, even in high-risk patients. This study found no evidence of cardiac decompensation or pulmonary vasoconstriction after protamine infusion.

    Area of Science:

    • Cardiology
    • Cardiovascular Surgery
    • Pharmacology

    Background:

    • Protamine administration is linked to potential cardiac decompensation.
    • Acute pulmonary vasoconstriction and right ventricular failure are concerns.
    • The effects of protamine on ventricular performance require detailed investigation.

    Purpose of the Study:

    • To assess the impact of protamine infusion on right and left ventricular function.
    • To evaluate hemodynamic changes during and after protamine administration.
    • To determine if protamine poses a risk to ventricular performance, especially in high-risk patients.

    Main Methods:

    • Prospective evaluation of right and left ventricular function in patients receiving protamine.
    • Hemodynamic measurements included right atrial pressure, right ventricular pressure, ejection fraction, pulmonary artery pressure, pulmonary capillary wedge pressure, cardiac output, blood pressure, and heart rate.

    Related Experiment Videos

  • Measurements were taken at multiple time points: pre-infusion, mid-infusion, post-infusion, and pre-sternal closure.

    • Main Results:

    • No significant changes were observed in right ventricular ejection fraction, end-diastolic pressure, mean pulmonary artery pressure, or pulmonary vascular resistance.
    • Left ventricular function remained stable throughout the study period.
    • No deterioration in ventricular function was noted even in patients with pulmonary artery hypertension (PAP > 25 mm Hg).

    Conclusions:

    • Protamine administration does not appear to consistently cause significant detrimental effects on right ventricular performance.
    • The study suggests protamine is hemodynamically safe for both right and left ventricular function.
    • Findings indicate that protamine can be safely administered without inducing significant cardiac compromise.