Reversal of heparin anticoagulation by protamine often produces hemodynamic changes such as hypotension, bradycardia, decreased cardiac output and various complications as anaphylactic reaction. Some studies have reported that intraaortic administration of protamine prevent profound hypotension and provide stable hemodynamics. The purpose of this study is to compare the hemodynamic changes following intraaortic and intravenous administration of protamine after cardiopulmonary bypass.

In a prospective double-blind trial, 30 patients undergoing cardiac valve replacement surgery were randomly assigned to receive intravenous protamine (n = 15) or intraaortic protamine (n = 15). Arterial pressure (AP), pulmonary arterial pressure (PAP), heart rate (HR), cardiac index (CI), systemic vascular resistance index (SVRI) and pulmonary vascular resistance index (PVRI) were measured.

The changes of HR, AP, PAP, CI, SVRI, PVRI were not significantly different between both groups. Both groups maintained hemodynamic stability afer protamine administration.

There were no significant difference in the hemodynamic changes following intraaortic and intravenous administration of protamine after cardiopulmonary bypass. And there were no hemodynamic benefits of intraaortic versus intravenous administration of protamine.