Effect of Lidocaine Pre-Treatment on Protamine-Induced Pulmonary Vascular Reaction During the Repair of Congenital Heart Disease

• Published in: International journal of general medicine Vol. 14; pp. 2249 - 2258
• Main Authors: Wang, Hong-Wu, Hu, Yi-Jin, Wang, Guo-Lin
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2021; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: adverse reactions; Anesthesia; Anticoagulants (Medicine); Arginine; Atracurium; Blood pressure; Blood transfusions; Cardiac function; Cardiac patients; Cardiovascular disease; China; Cisatracurium; Congenital diseases; Congenital heart disease; Diseases; Dopamine; Drug dosages; extracorporeal circulation; Health aspects; Heart diseases; Heart surgery; Lidocaine; Original Research; protamine; Pulmonary arteries; Pulmonary hypertension; Respiration; Sufentanil; Surgeons; Toxicology; Tranexamic acid; Veins & arteries; China; congenital heart disease; protamine; extracorporeal circulation; adverse reactions; pulmonary hypertension
• ISSN: 1178-7074; 1178-7074
• DOI: 10.2147/IJGM.S314541

Protamine is a polycationic, and a strong basic peptide isolated from Clupeidae or Salmonidae fishes' sperm, which is rich in arginine and highly alkaline. To explore the effect of lidocaine pre-treatment on protamine-induced pulmonary vascular reaction during the repair of congenital heart disease. Eighty patients undergoing repair of congenital heart disease were randomly divided into four groups: A (non-pulmonary hypertension + lidocaine pre-treatment) group, A (non-pulmonary hypertension + normal saline) group, B (pulmonary hypertension + lidocaine pre-treatment) group, and B (pulmonary hypertension + normal saline) group. Hemodynamic parameters, pulmonary inflammation, and pulmonary function were assessed at six intraoperative time points, two intraoperative time points and three intraoperative time points, respectively. -value <0.05 was considered statistically significant. A group exhibited increased PAP, Paw, RI and A-aDO . B group exhibited increased Paw, RI and A-aDO and decreased Cydn and OI after protamine administration. These changes were not observed in A and B group. Compared with A and B groups, plasma TXB level in A and B group was higher, but 6-keto-PGF in A and B groups was lower. Incidence of protamine adverse reactions in A and B group was lower than that in A and B group. Precondition of lidocaine before neutralization of heparin may be effective for protamine-induced pulmonary vascular reaction during CHD repair.