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Disadvantages of Prostacyclin Infusion During Cardiopulmonary Bypass: A Double-Blind Study of 50 Patients Having Coronary Revascularization
Journal article   Open access   Peer reviewed

Disadvantages of Prostacyclin Infusion During Cardiopulmonary Bypass: A Double-Blind Study of 50 Patients Having Coronary Revascularization

Verdi J. DiSesa, William Huval, Shlomo Lelcuk, Richard Jonas, Rosemarie Maddi, Stanley Lee-Son, Richard J. Shemin, John J. Collins, Herbert B. Hechtman and Lawrence H. Cohn
The Annals of thoracic surgery, v 38(5), pp 514-519
Nov 1984
DOI: https://doi.org/10.1016/S0003-4975(10)64194-X
PMID: 6388516
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1016/S0003-4975(10)64194-XView
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open

Abstract

Prostacyclin (PGI 2) has been suggested for use in cardiopulmonary bypass (CPB) because of its positive effects on platelet number and function. Fifty patients who underwent coronary artery bypass grafting using a bubble oxygenator received heparin, 3 mg per kilogram of body weight, and then were randomly assigned to receive PGI 2, 25 ng/kg/min, beginning 5 minutes before and until the end of CPB (26 patients) or a placebo (24 patients). Both groups were similar in sex, age, heparin dose, protamine dose, and CPB time. During CPB, mean arterial pressure fell significantly with PGI 2 (76 ± 2 mm Hg to 53 ± 2 mm Hg; p < 0.05) and necessitated pressor substances. Platelet counts fell significantly in both groups with the start of CPB, but after 60 minutes were similar in both groups (118 ± 9 × 10 3 versus 130 ± 8 × 10 3; not significant [NS]) and were unchanged 3 hours after CPB. Total chest tube output was 647 ± 51 ml (placebo group) versus 576 ± 34 ml (PGI 2 group) (NS); 18 of the patients given PGI 2 required 26 transfusions compared with 16 transfusions in 8 of the patients given a placebo ( p < 0.05). In PGI 2 patients, arterial oxygen tension on 100% oxygen fell from 281 ± 18 mm Hg before CPB to 223 ± 17 mm Hg immediately after CPB ( p < 0.05). The placebo patients did not show a change in this variable. There was a significant rise in thromboxane B 2 (TXB 2) from 150 ± 30 to 360 ± 60 pg/ml ( p < 0.05) during CPB in PGI 2 patients but it was not significantly increased in the placebo group (180 ± 30 to 270 ± 40 pg/ml; NS). At 25 ng/kg/min, PGI 2 has no demonstrable beneficial effect on platelet count or postoperative bleeding in patients having elective cardiac operations. Deleterious effects on mean arterial pressure, arterial oxygen tension, and TXB 2 levels during and after CPB are associated with administration of PGI 2 at this dosage.

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Web of Science research areas
Cardiac & Cardiovascular Systems
Respiratory System
Surgery
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