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.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL042397-03
Application #
3360588
Study Section
Surgery, Anesthesiology and Trauma Study Section (SAT)
Project Start
1990-07-01
Project End
1993-06-30
Budget Start
1992-07-01
Budget End
1993-06-30
Support Year
3
Fiscal Year
1992
Total Cost
Indirect Cost
Name
Massachusetts General Hospital
Department
Type
DUNS #
City
Boston
State
MA
Country
United States
Zip Code
02199
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