Protamine after heparin produces hypotension resulting from decreased sympathetic outflow secondary to increased nitric oxide in the central nervous system
| Autor: | Yoshiyuki Kameyama, Kirk T. Benson, Yoshikazu Hamada, Hiroshi Goto, Hideyuki Narita |
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| Rok vydání: | 2004 |
| Předmět: |
Central Nervous System
Male medicine.medical_specialty Sympathetic nervous system Protamine sulfate Baroreceptor Sympathetic Nervous System Blood Pressure Pressoreceptors Kidney Nitric Oxide Nitric oxide chemistry.chemical_compound Heart Rate Internal medicine Heart rate Medicine Animals Protamines Enzyme Inhibitors biology business.industry Heparin Heparin Antagonists Protamine Denervation Nitric oxide synthase Anesthesiology and Pain Medicine Endocrinology medicine.anatomical_structure NG-Nitroarginine Methyl Ester chemistry Anesthesia biology.protein Rabbits Hypotension Nitric Oxide Synthase business medicine.drug |
| Zdroj: | Anesthesia and analgesia. 100(1) |
| ISSN: | 0003-2999 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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