Different Hypotensive Responses to Intravenous Bovine and Human Thrombin Preparations in Swine

Authors:
  • JHJohn B. Holcomb
    John B. Holcomb
  • SBSambhu N. Bhattacharyya
    Sambhu N. Bhattacharyya
  • RHRichard A. Harris
    Richard A. Harris
  • RGRichard R. Gomez
    Richard R. Gomez
  • MMMartin J. MacPhee
    Martin J. MacPhee
  • JEJohn I. Enriquez
    John I. Enriquez
  • ADAngel V. Delgado
    Angel V. Delgado
  • NCNathaniel C. Charles
    Nathaniel C. Charles
  • JHJohn R. Hess
    John R. Hess
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Abstract
Accidental intravenous introduction of commercial bovine thrombin (BT) during use of fibrin glue may result in profound hypotension. Commercial human thrombin (HT) is now available. This study compared the effects of intravenous BT versus HT in swine. Swine received 30 U/kg BT, 60 U/kg BT, 30 U/kg HT, or 60 U/kg HT intravenously. Mean arterial pressure (MAP) and survival were monitored for 30 minutes. Thrombin purities and in vitro activities were examined. MAP nadir was lower (p < 0.05) after BT, 27.7 ± 3.3% (mean ± SEM) of pretreatment MAP, compared with 41.1 ± 3.7% after HT. Five of six animals died after 60 U/kg BT, whereas all others survived (p < 0.05). Histology suggested more severe disseminated intravascular coagulation after BT. HT was purer than BT. In vitro activities were similar. Both BT and HT produced hypotension. HT appeared safer, because of higher purity. Regardless of source and purity, thrombin must be used with caution.

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