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Haemodynamic effects of heparin during coronary bypass surgery
Author(s) -
Kongsgaard U. E.,
SmithErichsen N.,
Hysing E.,
Tølløfsrud S.,
Seem E.,
Geiran O.,
Bjørnskau L.
Publication year - 1991
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1991.tb03386.x
Subject(s) - medicine , heparin , bradykinin , kallikrein , hemodynamics , saline , kinin , vascular resistance , anesthesia , vasodilation , blood pressure , cardiac output , cardiology , chemistry , biochemistry , receptor , enzyme
Heparin has been suggested as an activator of the plasma kallikrein‐kinin system, with possible formation of bradykinin, a potent vasodilator. Haemodynamic effects and changes in the kallikrein‐kinin system were studied after heparin‐ and saline‐injections in ten patients undergoing coronary bypass surgery. A moderate decrease in mean arterial pressure was found in all patients in the observation period, but significantly more at 2 and 3 min after heparin‐injection compared with saline‐injection. None of the other haemodynamic variables measured were significantly different when comparing heparin‐ to saline‐injection. Heparin‐injection resulted in significant changes in the kallikrein‐kinin system, with a marked increase in spontaneous kallikrein‐like activity as the most prominent feature, while no changes were found after saline‐injection. Liberation of bradykinin would be expected to give a decrease in systemic vascular resistance with an increase in cardiac output. The results indicate that the plasma kallikrein‐kinin system, though apparently activated after heparin‐injection, does not contribute significantly to the decrease in arterial pressure in the patients studied.