THE BENEFICIAL-EFFECTS OF AMINOPHYLLINE ADMINISTRATION ON HEPARIN REVERSAL WITH PROTAMINE

The aim of this study was to demonstrate the beneficial effects of ami nophylline on protamine cardiotoxicity. Thirty-four patients were exam ined, 17 of whom received aminophylline 3 mg/kg before protamine admin istration, being the study group, while the other 17, being the contro l group, did not. All cardiac output and biochemical measurements were evaluated 5 min following protamine administration. The cAMP level wa s 43.4 +/- 3.51 pmol/ml in the study group and 18.7 +/- 2.98 in the co ntrol group (P < 0.0001) before protamine administration, while the ox ygen extraction rate decreased from 49% to 44 +/- 2% in the control gr oup, and from 51.2% to 47 +/- 3% in the study group (P < 0.03). The N- acetyl glucosaminidase value was 16.9 +/- 13.9 pmol/ml in the study gr oup and 27.8 +/- 1.47 pmol/ml in the control group (P < 0.01), and myo cardial lactate extraction was -0.20 +/- 0.03 in the control group and -0.07 +/- 0.07 in the study group (P < 0.001). The left ventricular s troke work index was 28.6 +/- 3.14 gm/m(2) in the control group and 37 +/- 6.77 gm/m(2) in the study group (P < 0.002). The findings of this study led us to conclude that the adverse effects of heparin neutrali zation using protamine can be relieved by aminophylline.