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Decreased oxygen consumption as a toxic manifestation of protamine sulfate reversal of heparin anticoagulation  Thomas W. Wakefield, MD, Ignacio Ucros,

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Presentation on theme: "Decreased oxygen consumption as a toxic manifestation of protamine sulfate reversal of heparin anticoagulation  Thomas W. Wakefield, MD, Ignacio Ucros,"— Presentation transcript:

1 Decreased oxygen consumption as a toxic manifestation of protamine sulfate reversal of heparin anticoagulation  Thomas W. Wakefield, MD, Ignacio Ucros, MD, Timothy F. Kresowik, MD, Daniel B. Hinshaw, MD, James C. Stanley, MD  Journal of Vascular Surgery  Volume 9, Issue 6, Pages (June 1989) DOI: / (89) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

2 Fig. 1 Blood pressure response to protamine reversal of heparin anticoagulation. Two-phased hypotensive response (at 60 and 180 seconds) is apparent. Journal of Vascular Surgery 1989 9, DOI: ( / (89) ) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

3 Fig. 2 Pulmonary artery pressure response to protamine reversal of heparin anticoagulation. Hypertensive response appears greatest at 90 seconds. Journal of Vascular Surgery 1989 9, DOI: ( / (89) ) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

4 Fig. 3 Cardiac output and carotid artery flow responses to protamine reversal of heparin anticoagulation. Journal of Vascular Surgery 1989 9, DOI: ( / (89) ) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

5 Fig. 4 Mixed venous systemic oxygen saturation and jugular venous oxygen saturation responses to protamine reversal of heparin anticoagulation. Journal of Vascular Surgery 1989 9, DOI: ( / (89) ) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

6 Fig. 5 Systemic and cerebral oxygen consumption changes after protamine reversal of heparin anticoagulation. Journal of Vascular Surgery 1989 9, DOI: ( / (89) ) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

7 Fig. 6 Portal venous and coronary venous oxygen saturation changes after protamine reversal of heparin anticoagulation. Journal of Vascular Surgery 1989 9, DOI: ( / (89) ) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

8 Fig. 7 Response to slow, 3-minute, protamine infusion (n = 5). Response was similar to that seen with rapid, 10-second, protamine infusion. Journal of Vascular Surgery 1989 9, DOI: ( / (89) ) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

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