Abstract

Hypotension Caused by Protamine with Pulmonary Arterial Hypertension

In cardiovascular surgery, protamine is a commonly used safe antidote for heparin reversal. Protamine was first used to help insulin formulations last longer. Because protamine interacts with platelets and fibrinogen while still acting as anticoagulant, just a little amount is administered to neutralise heparin in plasma. Protamine is linked to major Adverse Drug Reactions (ADRs) however they are uncommon, especially in patients with a history of protamine hypersensitivity. A 60-yearold diabetic male patient had had on-pump coronary artery bypass grafting at a tertiary care centre when he developed protamine-induced pulmonary arterial hypertension and peripheral vascular collapse. According to the causality, preventability, and severity assessment scale, this was a definite, non-preventable, severe ADR.


Author(s):

Marium Collins



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