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    Serum electrolytes and nitric oxide levels in acute hypotension following intravenous heparin
    (2006) Toprak H.I.; Begec Z.; But A.; Sizanli E.; Bayraktar N.; Ersoy M.O.
    Heparin is frequently used as an anticoagulant agent for patients undergoing surgery with cardiopulmonary bypass. In literature, severe hypotension as a side effect of high dose bolus heparin has been already reported. However, the exact mechanism of hypotension has not yet fully been understood. The aim of the study was to investigate the relationship between hemodynamic instability induced by heparin and levels of serum electrolytes and nitric oxide. Forty patients undergoing elective coronary artery bypass grafting were included into the study. Patients with sudden decrease in mean arterial pressure (MAP) higher than 25 % of the baseline after heparin administration were included into group H (n=20). Besides, consecutive twenty hemodinamically stabile patients (with none or a MAP decrease lower than 25 % of baseline) constituted group N (n=20). Anesthetic techniques were standardized. Arterial blood gases were analyzed for pH, PaO2, PaCO2, potassium, sodium, calcium, magnesium, hematocrit before and 5 minutes after heparin administration. Synchronous serum nitric oxide levels analysis were also performed. The nitric oxide levels were measured as reflected by the formation of its stable end-metabolites, nitrite and nitrate. Serum electrolyte and nitric oxide levels were not statistically different neither between before and after heparin administration nor between hypotension group and normotension group. Hypotension observed after heparin administration was not related with the concentration of serum electrolytes and nitric oxide.