Korean J Anesthesiol Search

CLOSE


Korean Journal of Anesthesiology 2002;43(2):157-164.
DOI: https://doi.org/10.4097/kjae.2002.43.2.157   
Effect of Calcium Chloride on Protamine Sulfate-Induced Systemic Hypotension in Adult Open-Heart Patients.
Seok Jai Kim, Chang Young Jeong, Sung Su Chung, In Ho Ha, Kyung Yeon Yoo
1Department of Anesthesiology, Chonnam National University Hospital, Chonnam National University Medical School, Korea. kyyoo@chonnam.ac.kr
2Department of Anesthesiology, College of Dentistry, Chonnam National University Medical School, Korea.
3The Research Institute of Medical Sciences, Chonnam National University Medical School, Korea.
4Seonam University Hospital, Gwangju, Korea.
Abstract
BACKGROUND
Protamine sulfate (PS), used to neutralize the anticoagulant effect of heparin, is often associated with systemic hypotension. The present study was aimed to investigate the protective effects of calcium chloride (CaCl2) on adverse hemodynamic reactions to PS in patients undergoing open heart surgery.
METHODS
After IRB approval, sixty-one patients undergoing open heart surgery were allocated randomly to receive either saline 10 ml (control group, n = 26), CaCl2 5 mg/kg (CaCl2 5 group, n = 18) or 10 mg/kg (CaCl2 10 group, n = 18), added to PS 3 mg/kg given over 3 min through the right atrium to reverse heparinization. Hemodynamic measurements, including systolic (SAP), diastolic (DAP), and mean arterial pressure (MAP), heart rate, and central venous pressure (CVP) were continuously recorded in a baseline condition and up to 10 minutes after PS infusion. Plasma Ca2+ level and arterial blood gas tension were also measured.
RESULTS
PS caused immediate and significant decreases in SAP, DAP, and MAP in all three groups. However, the degree of hypotension was significantly less in the CaCl2 10 group than in the CaCl2 5 and control groups. Heart rate and CVP remained unchanged throughout the study in all groups. Intravenous CaCl2 5 and 10 mg/kg IV caused an increase in plasma Ca2 by 0.13 +/- 0.08 mM and 0.45 0.08 mM at 2 min after its injection, respectively. Arterial oxygen tension did not change significantly throughout the study in any group.
CONCLUSIONS
These results suggest that simultaneous administration of 10 mg/kg CaCl2 attenuates the hypotensive effect of PS used to reverse heparin anticoagulation in patients undergoing open heart surgery. However, hypotensive reactions may still occur.
Key Words: Calcium chloride; hypotension; protamine sulfate


ABOUT
ARTICLE CATEGORY

Browse all articles >

BROWSE ARTICLES
AUTHOR INFORMATION
Editorial Office
101-3503, Lotte Castle President, 109 Mapo-daero, Mapo-gu, Seoul 04146, Korea
(서울특별시 마포구 마포대로 109 롯데캐슬 프레지던트 101동 3503호)
Tel: +82-2-792-5128    Fax: +82-2-792-4089    E-mail: journal@anesthesia.or.kr                
Business Name: Korean Society of Anesthesiologists (대한마취통증의학회)
Business Registration: 106-82-07194
Representative: Jun Heum Yon (연준흠)

Copyright © 2024 by Korean Society of Anesthesiologists.

Developed in M2PI

Close layer
prev next