Protamine and left ventricular function: A transesophageal echocardiography study

M. R. Del Re, J. D. Ayd, L. W. Schultheis, E. S. Heitmiller

Research output: Contribution to journalArticle

Abstract

The effect of protamine sulfate on left ventricular function was evaluated in 23 patients undergoing heart surgery requiring cardiopulmonary bypass (CPB). Ventricular function was assessed by measuring cardiac index with a thermodilution pulmonary artery catheter and fractional shortening with transesophageal echocardiography (TEE). After CPB, a heparin-neutralizing dose of protamine was infused continuously for 5 min. Hemodynamic variables were obtained and fractional shortening was measured before protamine administration (time 0), during protamine infusion (2.5 and 5 min), and after the infusion (10 and 15 min after the start of protamine). Patients with a preoperative ejection fraction ≥ 50% had no statistically significant changes in either cardiac index or fractional shortening with protamine administration, when compared to time 0. However, patients with a preoperative ejection fraction <50% had a significant decrease in fractional shortening which occurred during and immediately after protamine administration when compared to time 0 (P <0.01), with no associated change in hemodynamics. Our results suggest that protamine may have a negative inotropic effect that is apparent in patients with impaired ventricular function.

Original languageEnglish (US)
Pages (from-to)1098-1103
Number of pages6
JournalAnesthesia and Analgesia
Volume77
Issue number6
StatePublished - 1993

Fingerprint

Protamines
Transesophageal Echocardiography
Left Ventricular Function
Ventricular Function
Cardiopulmonary Bypass
Hemodynamics
Thermodilution
Pulmonary Artery
Thoracic Surgery
Heparin
Catheters

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Del Re, M. R., Ayd, J. D., Schultheis, L. W., & Heitmiller, E. S. (1993). Protamine and left ventricular function: A transesophageal echocardiography study. Anesthesia and Analgesia, 77(6), 1098-1103.

Protamine and left ventricular function : A transesophageal echocardiography study. / Del Re, M. R.; Ayd, J. D.; Schultheis, L. W.; Heitmiller, E. S.

In: Anesthesia and Analgesia, Vol. 77, No. 6, 1993, p. 1098-1103.

Research output: Contribution to journalArticle

Del Re, MR, Ayd, JD, Schultheis, LW & Heitmiller, ES 1993, 'Protamine and left ventricular function: A transesophageal echocardiography study', Anesthesia and Analgesia, vol. 77, no. 6, pp. 1098-1103.
Del Re MR, Ayd JD, Schultheis LW, Heitmiller ES. Protamine and left ventricular function: A transesophageal echocardiography study. Anesthesia and Analgesia. 1993;77(6):1098-1103.
Del Re, M. R. ; Ayd, J. D. ; Schultheis, L. W. ; Heitmiller, E. S. / Protamine and left ventricular function : A transesophageal echocardiography study. In: Anesthesia and Analgesia. 1993 ; Vol. 77, No. 6. pp. 1098-1103.
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