Effect of Lidocaine Pre-Treatment on Protamine-Induced Pulmonary Vascular Reaction During the Repair of Congenital Heart Disease.

BACKGROUND

Protamine is a polycationic, and a strong basic peptide isolated from Clupeidae or Salmonidae fishes' sperm, which is rich in arginine and highly alkaline.

OBJECTIVE

To explore the effect of lidocaine pre-treatment on protamine-induced pulmonary vascular reaction during the repair of congenital heart disease.

METHODS

Eighty patients undergoing repair of congenital heart disease were randomly divided into four groups: A (non-pulmonary hypertension + lidocaine pre-treatment) group, A (non-pulmonary hypertension + normal saline) group, B (pulmonary hypertension + lidocaine pre-treatment) group, and B (pulmonary hypertension + normal saline) group. Hemodynamic parameters, pulmonary inflammation, and pulmonary function were assessed at six intraoperative time points, two intraoperative time points and three intraoperative time points, respectively. -value <0.05 was considered statistically significant.

RESULTS

A group exhibited increased PAP, Paw, RI and A-aDO. B group exhibited increased Paw, RI and A-aDO and decreased Cydn and OI after protamine administration. These changes were not observed in A and B group. Compared with A and B groups, plasma TXB level in A and B group was higher, but 6-keto-PGF in A and B groups was lower. Incidence of protamine adverse reactions in A and B group was lower than that in A and B group.

CONCLUSION

Precondition of lidocaine before neutralization of heparin may be effective for protamine-induced pulmonary vascular reaction during CHD repair.