Hematologic changes occurring with cardiac catheterization.
The composition of the blood influences rheology and therefore might affect hemodynamics. During cardiac catheterization and angiography, blood is sampled and contrast media, fluid, and heparin are administered. To determine the effects of these perturbations on the blood cell count and coagulation, femoral vein samples were obtained at the beginning of cardiac catheterization, before heparin, 4,000 U; at the end, before protamine reversal; and after protamine, 40 mg, was administered. At the end of catheterization, 41 +/- 3 min after heparin administration, all cellular constituents were significantly lower than control: White (W) blood cells (BC) were 8.1 +/- 2.7% lower (P less than 0.05), red (R) BC, 10 +/- 1.8% (P less than 0.05), and platelets (P) 10.9 +/- 1.5% (P less than 0.05). Protamine lowered further WBC by 23 +/- 4% (P less than 0.05 and P) by 14 +/- 2% (P less than 0.05), but did not change RBC (4.13 +/- 0.20 x 10(6) to 4.25 +/- 0.23 x 10(6]. Before protamine administration, all patients had a partial thromboplastin time (PTT) 1.5 times the control value and ten of 13 patients had a value greater than 100 sec. Although four of 13 patients had an incomplete reversal of PTT after protamine, none suffered an untoward event. In conclusion, cardiac catheterization produces changes in the cellular composition of the blood, and such changes might influence hemodynamic measurements.
Friedman, HS; Trivelli, LA; Nguyen, T; Benamor, R; Dorsa, M
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