Adt M, Reimann H J, Schmucker P, Kuppe H, Weinhold C
Institut für Anaesthesiologie am Deutschen Herzzentrum Berlin.
J Cardiovasc Surg (Torino). 1989 Mar-Apr;30(2):250-6.
Several reports, dealing with typical cardiovascular reactions immediately after injection of heparin during cardiac surgery, have been presented. A possible reason for these reactions is a short-lasting elevation of plasma histamine concentration following heparin injection. As most types of heparin contain antibacterial preservatives such as benzyl alcohol, which can cause adverse reactions, both substances, heparin itself and the preservative, can theoretically be responsible for this reaction. Therefore, this study was carried out in order to measure the effects of preservative-free heparin on plasma-histamine levels and on hemodynamic parameters. It became evident that preservative-free heparin also entails characteristical hemodynamic effects, such as a decrease in arterial mean pressure and peripheral vascular resistance as well as an increase in cardiac output. A significant increase in plasma-histamine concentration could be shown 20-120 seconds after injection of heparin. We conclude that benzyl alcohol is not the major reason for the hemodynamic effects and elevation of plasma-histamine concentration, following heparin injection, but we cannot exclude that benzyl alcohol does in fact play a minor role. The results of this study suggest that the cardiovascular reactions and the elevation of plasma histamine concentration following heparin injection are heparin-specific phenomena.
已有多篇报告阐述了心脏手术期间注射肝素后立即出现的典型心血管反应。这些反应的一个可能原因是注射肝素后血浆组胺浓度短暂升高。由于大多数类型的肝素含有抗菌防腐剂，如苯甲醇，而苯甲醇会引起不良反应，理论上肝素本身和防腐剂这两种物质都可能导致这种反应。因此，开展本研究以测定不含防腐剂的肝素对血浆组胺水平和血流动力学参数的影响。结果表明，不含防腐剂的肝素也会产生典型的血流动力学效应，如动脉平均压和外周血管阻力降低以及心输出量增加。注射肝素后20 - 120秒，血浆组胺浓度显著升高。我们得出结论，苯甲醇不是肝素注射后血流动力学效应和血浆组胺浓度升高的主要原因，但我们不能排除苯甲醇实际上确实起了次要作用。本研究结果表明，肝素注射后的心血管反应和血浆组胺浓度升高是肝素特异性现象。
