Use of epoprostenol to treat severe pulmonary vasoconstriction induced by protamine in cardiac surgery.

Abstract:

:Since there were a few articles to report the treatment of severe pulmonary vasoconstriction induced by protamine in cardiac surgery, we described the use of epoprostenol to reverse this condition.A total of 5 cases of severe pulmonary vasoconstriction induced by protamine in cardiac surgery were reviewed. The demographic, clinical data and treatment process were obtained. All the patients were followed up.Severe pulmonary vasoconstriction was occurred 4 to 10 minutes after protamine infusion. The primary sign was sudden hypotension, the pulmonary artery pressure was increased gradually, the arterial oxygen partial pressure was decreased in all the patients. Epoprostenol was infused via pulmonary artery catheter at dosage of 20 to 40 ng/kg·min in all the patients, 2 patients were underwent re-cardiac pulmonary bypass assistance. The hemodynamic instability status lasted 40 to 65 minutes respectively. All the patients were recovered uneventfully.All physicians should alert to the incidence of severe pulmonary vasoconstriction induced by protamine in cardiac surgery. Use epoprostenol through pulmonary artery catheter could treat pulmonary artery vasoconstriction effectively and safely.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Guan Z,Shen X,Zhang YJ,Li XG,Gao YF,Tan J,Yuan H,Liu JJ

doi

10.1097/MD.0000000000010908

subject

Has Abstract

pub_date

2018-07-01 00:00:00

pages

e10908

issue

28

eissn

0025-7974

issn

1536-5964

pii

00005792-201807130-00001

journal_volume

97

pub_type

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