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. 2005 Jan;100(1):33-37.
doi: 10.1213/01.ANE.0000139357.87358.94.

Protamine after heparin produces hypotension resulting from decreased sympathetic outflow secondary to increased nitric oxide in the central nervous system

Yoshikazu Hamada  1 , Yoshiyuki Kameyama, Hideyuki Narita, Kirk T Benson, Hiroshi Goto
Affiliations

Protamine after heparin produces hypotension resulting from decreased sympathetic outflow secondary to increased nitric oxide in the central nervous system

Yoshikazu Hamada et al. Anesth Analg. 2005 Jan.

Abstract

To elucidate whether there are linkages among protamine-induced hypotension, nitric oxide (NO), and sympathetic nerve activity, we administered 3 mg/kg protamine sulfate after 300 U/kg heparin after 20 mg/kg of N(G)-nitro-D-arginine methyl ester (D-NAME) or N(G)-nitro-L-arginine methyl ester (L-NAME) as a pretreatment to baroreceptor-denervated rabbits and compared changes in hemodynamic variables and renal sympathetic nerve activity (RSNA). In the D-NAME group, heart rate (HR), mean arterial blood pressure (MAP), and RSNA significantly decreased to 93.7% +/- 0.7%, 75.0% +/- 5.1% and 65.2% +/- 4.6% (mean +/- SE), respectively. In the L-NAME group, the pretreatment of L-NAME significantly inhibited the depressant effects of protamine on these variables. Because the animals were totally baroreceptor-denervated, decreased RSNA was attributable to the central depressant effect of protamine, and decreased sympathetic outflow could have contributed to the reduction of HR and MAP. The depressant effect of protamine on sympathetic outflow was inhibited by the pretreatment with L-NAME, a NO synthase inhibitor, suggesting that decreased sympathetic outflow secondary to a protamine-induced increase in NO concentration in the central nervous system may contribute to protamine-induced cardiovascular depression.

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References

    1. Goto H, Kushihashi T, Benson KT, et al. Heparin, protamine and ionized calcium in vitro and in vivo. Anesth Analg 1985;64:1081–4.
    1. Raikar GV, Hisamochi K, Raikar BLN, et al. Cardiopulmonary bypass, myocardial management and support techniques. J Thorac Cardiovasc Surg 1996;111:1240–7.
    1. Jimbo M, Suzuki H, Ichikawa M, et al. Role of nitric oxide in regulation of baroreceptor reflex. J Auton Nerv Syst 1994;50:209–19.
    1. Sakuma I, Togashi H, Yoshioka M, et al. NG-methyl-l-arginine, an inhibitor of l-arginine-derived nitric oxide synthesis, stimulates renal sympathetic nerve activity in vivo. Circ Res 1992;70:607–11.
    1. Taneyama C, Goto H, Goto K, et al. Attenuation of arterial baroreceptor reflex response to hypovolemia during induced hypotension. Anesthesiology 1990;73:433–40.

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