Absence of complement-mediated events after protamine reversal of heparin anticoagulation
dc.contributor.author | Wakefield, Thomas W. | en_US |
dc.contributor.author | Kirsh, Marvin M. | en_US |
dc.contributor.author | Till, Gerd O. | en_US |
dc.contributor.author | Brothers, Thomas E. | en_US |
dc.contributor.author | Hantler, Charles B. | en_US |
dc.contributor.author | Stanley, James C. | en_US |
dc.date.accessioned | 2006-04-10T14:39:44Z | |
dc.date.available | 2006-04-10T14:39:44Z | |
dc.date.issued | 1991-07 | en_US |
dc.identifier.citation | Wakefield, Thomas W., Kirsh, Marvin M., Till, Gerd O., Brothers, Thomas E., Hantler, Charles B., Stanley, James C. (1991/07)."Absence of complement-mediated events after protamine reversal of heparin anticoagulation." Journal of Surgical Research 51(1): 72-76. <http://hdl.handle.net/2027.42/29240> | en_US |
dc.identifier.uri | http://www.sciencedirect.com/science/article/B6WM6-4BNG38R-VC/2/21211f2cf93c0fcf14a8a7fea06ab12c | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/29240 | |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=2067362&dopt=citation | en_US |
dc.description.abstract | Protamine reversal of heparin anticoagulation is associated with adverse hemodynamic effects that may be attenuated with protamine pretreatment (PP). This study assesses the role of complement activation during these phenomena in adult cardiac surgery patients. Sixteen individuals undergoing cardiopulmonary bypass were given intravenous normal saline or protamine (2 mg/kg) as a randomized pretreatment prior to undergoing heparin anticoagulation (400 IU/kg), coronary artery revascularization, and subsequent reversal of the anticoagulated state with protamine (4 mg/kg). Blood pressure, pulmonary artery diastolic pressure (PAD), heart rate, and cardiac output (CO) were measured during and after pretreatment, prior to heparin reversal by protamine, and for 10 min after reversal. Total hemolytic complement (CH50), C3 conversion to C3b, C3a/C5a, platelet count, and white blood cell count (WBC) were also measured at the same time periods. No significant correlation existed between complement activation and hemodynamic events, as might have been evident by decreased CH50, increased C3 conversion to C3b, or elevations in C3a/C5a levels. PP significantly prevented the CO decrease occurring at 1 and 3 min following heparin reversal by protamine (-0.8 and -1.4 liters/min vs 0.1 and -0.2 liters/min, P P P = 0.06). These data support the conclusion that, contrary to earlier reports, adverse hemodynamic and hematologic responses accompanying protamine reversal of heparin anticoagulation do not appear to be correlated with activation of complement. In fact, those patients having the greatest C3a generation exhibited the least hemodynamic changes. | en_US |
dc.format.extent | 670451 bytes | |
dc.format.extent | 3118 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.language.iso | en_US | |
dc.publisher | Elsevier | en_US |
dc.title | Absence of complement-mediated events after protamine reversal of heparin anticoagulation | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Surgery and Anesthesiology | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Sections of Vascular Surgery and Thoracic Surgery, Department of Surgery, Department of Pathology, and Department of Anesthesiology, University of Michigan Medical Center, Ann Arbor, Michigan 48109, USA | en_US |
dc.contributor.affiliationum | Sections of Vascular Surgery and Thoracic Surgery, Department of Surgery, Department of Pathology, and Department of Anesthesiology, University of Michigan Medical Center, Ann Arbor, Michigan 48109, USA | en_US |
dc.contributor.affiliationum | Sections of Vascular Surgery and Thoracic Surgery, Department of Surgery, Department of Pathology, and Department of Anesthesiology, University of Michigan Medical Center, Ann Arbor, Michigan 48109, USA | en_US |
dc.contributor.affiliationum | Sections of Vascular Surgery and Thoracic Surgery, Department of Surgery, Department of Pathology, and Department of Anesthesiology, University of Michigan Medical Center, Ann Arbor, Michigan 48109, USA | en_US |
dc.contributor.affiliationum | Sections of Vascular Surgery and Thoracic Surgery, Department of Surgery, Department of Pathology, and Department of Anesthesiology, University of Michigan Medical Center, Ann Arbor, Michigan 48109, USA | en_US |
dc.contributor.affiliationum | Sections of Vascular Surgery and Thoracic Surgery, Department of Surgery, Department of Pathology, and Department of Anesthesiology, University of Michigan Medical Center, Ann Arbor, Michigan 48109, USA | en_US |
dc.identifier.pmid | 2067362 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/29240/1/0000295.pdf | en_US |
dc.identifier.doi | http://dx.doi.org/10.1016/0022-4804(91)90072-T | en_US |
dc.identifier.source | Journal of Surgical Research | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
Files in this item
Remediation of Harmful Language
The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.
Accessibility
If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.