Download PDF
Thromb Haemost 1983; 49(01): 001-004
DOI: 10.1055/s-0038-1657302
Original Article
Schattauer GmbH Stuttgart

Hemodynamic and Platelet Response to the Bolus Intravenous Administration of Porcine Heparin

David G Bjoraker
The Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, U. S. A.
,
Thomas R Ketcham
The Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, U. S. A.
› Author Affiliations
Further Information

Publication History

Received 10 August 1982

Accepted 15 November 1982

Publication Date:
18 July 2018 (online)

  PDF Download  Permissions and Reprints

Summary

There is considerable evidence that under some conditions intravenous heparin infusion may cause or at least enhance platelet aggregation in vivo. Reports of heparin-induced vasodilatation and decreases in arterial blood pressure have not been accompanied by simultaneous observations of the platelet response. In this study both the hemodynamic and platelet response to the bolus administration of porcine intestinal mucosa sodium heparin were monitored in 24 cardiac and 12 vascular surgery patients. Mean arterial blood pressure decreased 7.1 ± 0.8 mmHg as a result of a 247 ± 34 dyne · sec/cm5 decrease in systemic vascular resistance. Platelet count, platelet volume distribution, and beta-thromboglobulin levels did not change with heparin infusion. These responses did not differ when comparing the 155 unit/kg group and the 400 unit/kg group or the 400 unit/ kg groups treated with different commercial preparations. The single patient who did have a decrease in platelet count and a severe rise in beta-thromboglobulin with heparin died intraoperat- ively of a massive myocardial infarction. Large increases in platelet factor 4 with heparin administration were not associated with platelet release but were dependent on whether or not the patient was treated with preoperative subcutaneous or intravenous heparin. There was no evidence that heparin-induced vasodilatation was mediated by platelet aggregation and release.

Keywords

Beta-thromboglobulin - Heparin - Platelet aggregation - Platelet factor 4 - Platelet release
 

  • References

  • 1 Zucker MB. 1977; 36: 47-49
    PubMed
  • 2 Carreras LO. Thrombosis and thrombocytopenia induced by heparin. Scand J Haematol 1980; 36 (Suppl) 64-80
    PubMedGoogle Scholar
  • 3 Fidlar E, Jaques LB. The effect of commercial heparin on the platelet count. J Lab Clin Med 1948; 33: 1410-1423
    PubMedGoogle Scholar
  • 4 Gollub S, Ulin AW. Heparin-induced thrombocytopenia in man. J Lab Clin Med 1962; 59: 430-435
    PubMedGoogle Scholar
  • 5 Borchgrevink CF. The mechanism of the prolonged bleeding time provoked by dextran sulphate or by excessive doses of heparin. Acta Med Scand 1961; 170: 365-373
    PubMedGoogle Scholar
  • 6 Salzman EW. Blood platelets and extracorporeal circulation. Transfusion 1963; 03: 274-277
    CrossrefPubMedGoogle Scholar
  • 7 Davey MG, Lander H. Effect of injected heparin on platelet levels in man. J Clin Pathol 1968; 21: 55-59
    CrossrefPubMedGoogle Scholar
  • 8 Nordoy A, Storm E, Berntsen H. The effect of heparin on plasma and platelet lipids during alimentary hyperlipaemia in man. Scand J Haematol 1974; 13: 72-80
    PubMedGoogle Scholar
  • 9 Reches A, Eldor A, Salomon Y. Heparin inhibits PGErsensitive adenylate cyclase and antagonizes PGE, anti aggregating effect in human platelets. J Lab Clin Med 1979; 93: 638-644
    PubMedGoogle Scholar
  • 10 Saba HI, Saba SR, Blackburn CA, Hartmann RC, Mason RG. Heparin neutralization of PGI2: effects upon platelets. Science 1979; 205: 499-501
    CrossrefPubMedGoogle Scholar
  • 11 Lewy RI. Effect of elevated plasma-free fatty acids on thromboxane release in patients with coronary artery disease. Haemostasis 1980; 09: 134-140
    PubMedGoogle Scholar
  • 12 Swedenborg J. Vasoactivity of adenine nucleotides released in vitro from blood cells by thrombin. Acta Physiol Scand 1970; 79: 359-368
    CrossrefPubMedGoogle Scholar
  • 13 Seltzer JL, Gerson JI. Decrease in arterial pressure following heparin injection prior to cardiopulmonary bypass. Acta Anaesthesiol Scand 1979; 23: 575-578
    CrossrefPubMedGoogle Scholar
  • 14 Abrahams DG, Howarth S. A peripheral action of heparin. Br Heart J 1950; 12: 429
    PubMedGoogle Scholar
  • 15 Paulus JM. Platelet size in man. Blood 1975; 46: 321-336
    PubMedGoogle Scholar
  • 16 Radegran K, Drugge U, Olsson P. Pulmonary venoconstriction by induced platelet aggregation. Acta Anaesthesiol Scand 1974; 18: 243-247
    CrossrefPubMedGoogle Scholar
  • 17 Vaage J. Intravascular platelet aggregation and acute respiratory insufficiency. Circ Shock 1977; 04: 279-290
    PubMedGoogle Scholar
  • 18 McLean MR, Hause LL. The effect of bovine lung heparin on normal human platelets as measured by electronic particle size analysis. Thromb Haemostas 1982; 47: 5-7
    PubMedGoogle Scholar
  • 19 Kohanna F, Ransil B, Smith MA, Salzman EW. Sex difference in heparin induced platelet aggregation in whole blood. Thromb Haemostas 1981; 46: 378 (Abstr.)
    PubMedGoogle Scholar
  • 20 Smitherman TC, Milam M, Woo J, Willerson J T, Frenkel EP. Elevated beta thromboglobulin in peripheral venous blood of patients with acute myocardial ischemia: direct evidence for enhanced platelet reactivity in vivo. Am J Cardiol 1981; 48: 395-402
    CrossrefPubMedGoogle Scholar
  • 21 Rasi V, Ikkala E, Torstila I. Plasma β-thromboglobulin in acute myocardial infarction. Thromb Res 1982; 25: 203-212
    CrossrefPubMedGoogle Scholar
  • 22 Dawes J, Smith RC, Pepper DS. The release, distribution, and clearance of human β-thromboglobulin and platelet factor 4. Thromb Res 1978; 12: 851-861
    CrossrefPubMedGoogle Scholar
  • 23 Celia G, Casonato A, Visintin L, Girolami A. Heparins and release. Thromb Haemostas 1980; 44: 105
    PubMedGoogle Scholar