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Successful Treatment of Anaphylactic Shock after Protamine Administration-Report of a Case | OMICS International | Abstract
ISSN: 2165-7548

Emergency Medicine: Open Access
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Case Report

Successful Treatment of Anaphylactic Shock after Protamine Administration-Report of a Case

Chih-Hsien Lee1-3*, Han-Chin Cheng2, Li-Wei Ko2

1Department of Cardiac Surgery, Tungs’ Taichung MetroHarbor Hospital, Taichung City 435, Taiwan

2Department of Biological Science and Technology, National ChiaoTung University, Hsinchu City, Taiwan

3Department of Surgery, National Defense Medical Center, Taiwan

*Corresponding Author:
Chih-Hsien Lee
Department of Cardiac Surgery
Tungs’ Taichung MetroHarbor Hospital
Wuqi Dist, Taichung City 435, Taiwan
Tel: +886-4- 26581919
E-mail: [email protected]

Received Date: September 08, 2013; Accepted Date: September 23, 2013; Published Date: September 25, 2013

Citation: Lee CH, Cheng HC, Ko LW (2013) Successful Treatment of Anaphylactic Shock after Protamine Administration-Report of a Case. Emergency Med 3:157. doi:10.4172/2165-7548.1000157

Copyright: © 2013 Lee CH, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Protamine sulfate is administered intravenously to reverse heparin induced anticoagulation during open heart surgery. Allergic reactions to protamine occur sporadically, but arguably with increased incidence in diabetic patients, especially those who receive protamine zinc insulin preparations, patients with true fish allergy or a history of previous protamine exposure, and those who have undergone vasectomy. Adverse effects of protamine administration vary from urticaria and rash to systemic hypotension, bronchospasm, pulmonary hypertension, cardiovascular collapse, and death. The most common reaction in adults is a transient decrease in systemic arterial blood pressure, which is usually associated with the rate of administration. Despite adverse effects, it remains widely used for this purpose. Life-threatening reactions to protamine, although extremely rare, entail substantial risk. We are herein report a case of coronary artery disease received the coronary artery bypass grafting and then life-threatening reactions to cardiovascular collapse after protamine administration without risk factor.