HEPARIN-PROTAMINE LUNG VASOCONSTRICTION AT HEART SURGERY

在前瞻性随机研究中，我们将阻止导致 当肝素抗凝被逆转时导致心肺衰竭 鱼精蛋白。925例心脏手术患者的近期前瞻性研究 马萨诸塞州综合医院的手术我们发现了14名患者(1.5%) 出现急性短暂性肺动脉高压，与明显 增加的血液血栓素水平(一个强大的二十烷类肺 血管收缩药)。当情况严重时，这种反应会引起休克， 支气管收缩和死亡。我们之前的动物和临床研究已经 探索这种不良药物相互作用的生化途径，以及 确定了阻止反应的关键点。在一项试验性临床研究中，我们 将检查血栓烷受体阻滞剂以了解IE是否足够 在心脏手术中使用安全。然后我们将测试竞争对手 血栓烷受体拮抗剂能够阻断这一反应 1250例心脏手术患者的前瞻性随机研究。

In prospective randomized study we will block the key mediator that leads to cardiopulmonary collapse when heparin anticoagulation is reversed by protamine. In recent prospective study of 925 patients undergoing cardiac surgery at Massachusetts General Hospital we found 14 patients (1.5%) developed acute transient pulmonary hypertension associated with markedly increased blood thromboxane levels (a powerful eicosanoid pulmonary vasoconstrictor). When severe, this reaction can cause shock, bronchoconstriction and death. Our prior animal and clinical studies have probed the biochemical pathways of this adverse drug interaction, and identified a key point to block the reaction. In a pilot clinical study we will examine a thromboxane receptor blocker to learn if ie is sufficiently safe for use at cardiac surgery. Then we will test the competitive thromboxane receptor inhibitor for is ability to block this reaction in a prospective randomized study of 1250 patients undergoing heart surgery.