Noncardiogenic pulmonary edema associated with protamine administration during coronary artery bypass graft surgery

Protamine sulfate is the only agent approved to reverse heparin-induced ant icoagulation. As with any other drug, protamine has the potential to cause adverse effects that range from mild hypotension to potentially fatal event s, such as noncardiogenic pulmonary edema (NCPE) and catastrophic pulmonary vasoconstriction. We report a case of NCPE after the administration of pro tamine to a patient undergoing coronary artery bypass graft surgery and dis cuss the diagnosis and management of this severe adverse event. (C) 2000 by Elsevier Science Inc.