Decreased oxygen consumption as a toxic manifestation of protamine sulfate reversal of heparin anticoagulation Thomas W. Wakefield, MD, Ignacio Ucros,

Slides:

Advertisements

Similar presentations

Timing of carotid endarterectomy after acute stroke Joseph J. Plotrowski, MD, Victor M. Bernhard, MD, Jeffrey R. Rubin, MD, Kenneth E. McIntyre, MD, James.

Advertisements

The role of arteriovenous shunts in the pathogenesis of varicose veins Howard C. Baron, M.D., Sebastiano Cassaro, M.D. Journal of Vascular Surgery Volume.

The effect of inguinal lymphatic manipulation on regional lymph flow patterns Jeffrey R. Rubin, MD, Lisa B. Eberlin, MD Journal of Vascular Surgery Volume.

Heparin-coated catheters and heparin-induced thrombocytopenia

Daniel J. Lindner, M. D. , James M. Edwards, M. D. , Edward S

Elastin, collagen, and some mechanical aspects of arterial aneurysms

William B. Schroder, MD, John F. Bealer, MD

Axillary-to-carotid artery bypass grafting for symptomatic severe common carotid artery occlusive disease Joseph P. Archie, PhD, MD Journal of Vascular.

Gastroesophageal tumor embolization to the popliteal arteries

Presidential address: Energy, poise, and resilience—Daniel Bernoulli, Thomas Young, J. L. M. Poiseuille, and F. A. Simeone Robert W. Hopkins, MD Journal.

Duplex ultrasound measurement of changes in mesenteric flow velocity with pharmacologic and physiologic alteration of intestinal blood flow in man Michael.

Mycotic axillary artery aneurysm

A new valvulotome for in situ bypass grafts

Walter J. Scott, M.D., Bruce L. Gewertz, M.D.

Mesenteric and portal vein thrombosis in a young patient with protein S deficiency treated with urokinase via the superior mesenteric artery Deron J.

Jeffrey R. Rubin, M.D., James M. Malone, M.D., Jerry Goldstone, M.D.

Malcolm O. Perry, MD, Richard Kempczinski, MD

Protecting the brain and spinal cord

David Rosenthal, MD, Edgar Borrero, MD, Michael D. Clark, MD, Pano A

Efficacy and toxicity of differently charged polycationic protamine-like peptides for heparin anticoagulation reversal Alphonse DeLucia, MD, Thomas W.

Blunt trauma to the carotid arteries

Heparin-coated catheters and heparin-induced thrombocytopenia

Milton M. Slocum, MD, John G. Adams, MD, Rosemary Teel, MT, Donald P

Abdominal aortic aneurysm: A general defect in the vasculature with focal manifestations in the abdominal aorta? Björn Sonesson, MD, PhD, Flemming Hansen,

Daniel J. Lindner, M. D. , James M. Edwards, M. D. , Edward S

Reduction of hospital resources utilization in vascular surgery: A four-year experience Sean P. Roddy, MD, Thomas F. O'Donnell, MD, Mark D. Iafrati, MD,

Sequestration of platelets in the pulmonary circulation as a consequence of protamine reversal of the anticoagulant effects of heparin Thomas W. Wakefield,

Objective tinnitus resulting from internal carotid artery stenosis

Intraoperative arteriography and carotid surgery

Depressed cardiovascular function and altered platelet kinetics following protamine sulfate reversal of heparin activity Thomas W. Wakefield, M.D., Walter.

Eric S. Berens, MD, Nicholas T. Kouchoukos, MD, Suzan F

Glossopharyngeal nerve injury complicating carotid endarterectomy

The Journal of Vascular Surgery: 1982 to 1990

Treatment of venous disease – The innovators

Lower extremity ischemia in adults younger than forty years of age: A community-wide survey of premature atherosclerotic arterial disease Pavel J. Levy,

Calvin B. Ernst, MD Journal of Vascular Surgery

Provoked compliance of the supernormal popliteal vein

James R. Burnett, MB, BS, FRACS, Robert J. Lusby, MD, FRCS, FRACS

Timothy J. Gardner, M. D. , Peter J. Horneffer, M. D. , Teri A

Mesenteric venous thrombosis

Evaluation of carotid artery stenosis: Is duplex ultrasonography sufficient? Paula M. Muto, MD, Harold J. Welch, MD, William C. Mackey, MD, Thomas F.

Cardiovascular surgery—The rocket and its stars: Presidential address

The role of a defined protocol for cardiac risk assessment in decreasing perioperative myocardial infarction in vascular surgery T.J. Bunt, MD Journal.

James W. Geuder, MD, Patrick J. Lamparello, MD, Thomas S

Composite sequential bypasses to the ankle and beyond for limb salvage

Research and research funding in vascular surgery

Regarding “Venous ulcers and the superficial venous system”

Safer shunt insertion during carotid endarterectomy

Carotid endarterectomy in the octogenarian: Is it appropriate?

J.Dennis Baker, MD Journal of Vascular Surgery

Septic embolism complicating infective endocarditis

Victor J. Celani, MD, William Gee, MD, Harry A. Kaupp, MD, Theodore J

Substitution by adenosine for glucagon as a surgical diagnostic tool to detect mesenteric vascular adaptation István Dóbi, MD, Alexander Juhász-Nagy,

Concomitant cardiac and vascular disease: “Through the looking glass”

Richard L. McCann, M.D., Raymond Makhoul, M.D., Ralph Damiano, M.D.

Seizures following subclavian-carotid bypass

Jay B. Fisher, MD, Marc A. Granson, MD Journal of Vascular Surgery

Should patient age be a consideration in carotid endarterectomy?

Exposure of femoral vessels by a suprainguinal incision

Monitoring vascular surgical performance

Chronic digitalis administration alters mesenteric vascular reactivity

Carotid endarterectomy for nonhemispheric cerebral symptoms: Patient selection with ocular pneumoplethysmography Kenneth Ouriel, M.D., John J. Ricotta,

D. Emerick Szilagyi, MD—An appreciation

Superficial temporal artery aneurysms

Presidential address: The second-generation vascular surgeon

George D. Lilly 1906–1988 Journal of Vascular Surgery

James A. DeWeese, MD Journal of Vascular Surgery

Axillary-to-carotid artery bypass grafting for symptomatic severe common carotid artery occlusive disease Joseph P. Archie, PhD, MD Journal of Vascular.

Innominate artery trauma: A thirty-year experience

Cornelius A. Sullivan, MD, Michael J. Rohrer, MD, Bruce S. Cutler, MD

Presentation transcript:

Decreased oxygen consumption as a toxic manifestation of protamine sulfate reversal of heparin anticoagulation Thomas W. Wakefield, MD, Ignacio Ucros, MD, Timothy F. Kresowik, MD, Daniel B. Hinshaw, MD, James C. Stanley, MD Journal of Vascular Surgery Volume 9, Issue 6, Pages 772-777 (June 1989) DOI: 10.1016/0741-5214(89)90084-0 Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Blood pressure response to protamine reversal of heparin anticoagulation. Two-phased hypotensive response (at 60 and 180 seconds) is apparent. Journal of Vascular Surgery 1989 9, 772-777DOI: (10.1016/0741-5214(89)90084-0) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Pulmonary artery pressure response to protamine reversal of heparin anticoagulation. Hypertensive response appears greatest at 90 seconds. Journal of Vascular Surgery 1989 9, 772-777DOI: (10.1016/0741-5214(89)90084-0) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Cardiac output and carotid artery flow responses to protamine reversal of heparin anticoagulation. Journal of Vascular Surgery 1989 9, 772-777DOI: (10.1016/0741-5214(89)90084-0) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Mixed venous systemic oxygen saturation and jugular venous oxygen saturation responses to protamine reversal of heparin anticoagulation. Journal of Vascular Surgery 1989 9, 772-777DOI: (10.1016/0741-5214(89)90084-0) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Systemic and cerebral oxygen consumption changes after protamine reversal of heparin anticoagulation. Journal of Vascular Surgery 1989 9, 772-777DOI: (10.1016/0741-5214(89)90084-0) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Portal venous and coronary venous oxygen saturation changes after protamine reversal of heparin anticoagulation. Journal of Vascular Surgery 1989 9, 772-777DOI: (10.1016/0741-5214(89)90084-0) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 7 Response to slow, 3-minute, protamine infusion (n = 5). Response was similar to that seen with rapid, 10-second, protamine infusion. Journal of Vascular Surgery 1989 9, 772-777DOI: (10.1016/0741-5214(89)90084-0) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions