title: Platelet preservation during cardiopulmonary bypass with iloprost and Duraflo-II heparin-coated surfaces.
abstract: To test the hypothesis that temporary platelet inhibition during cardiopulmonary bypass (CPB) with surface heparinized systems may result in platelet preservation, nine Yorkshire pigs were placed on CPB for 3 hours. Platelet labeling was done in all pigs with Indium-111 tropolone. CPB was instituted with a roller pump, a hollow fiber membrane oxygenator (Bentley CM-50 [Baxter-Bentley Laboratories, Irvine, CA]), and an arterial filter. The extracorporeal perfusion systems were surface-coated with the Duraflo-II heparin complex. Group A pigs (n = 5) were systemically heparinized (activated coagulation time longer than 400 sec). Group B pigs (n = 4) were placed on CPB without systematic heparinization, but have received the stable prostacyclin-analog Iloprost (ZK36374) at 1 ng/kg/min i.v. from 30 min before and during CPB. Platelet counts declined in group A pigs at 5 min, 1 hr, 2 hr, and 3 hr of CPB to 79.8% (mean), 66.5%, 71.3%, and 69.0% of pre-CPB values, respectively (p less than 0.05). In group B pigs, mean platelet count during CPB was higher than 90% of control value. Percentage of injected radioactivity detected in the oxygenator was 2.82% in group A pigs versus 0.73% in group B pigs (p = 0.0541). Surface heparinization with the Duraflo II heparin coating complex in combination with Iloprost-induced temporary platelet inhibition resulted in platelet count preservation during CPB in the pig model.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, University of Miami School of Medicine, Florida 33101.
authors.forename: G M
authors.initials: GM
authors.lastname: Palatianos
authors.forename: M K
authors.initials: MK
authors.lastname: Dewanjee
authors.forename: W
authors.initials: W
authors.lastname: Smith
authors.forename: S
authors.initials: S
authors.lastname: Novak
authors.forename: L C
authors.initials: LC
authors.lastname: Hsu
authors.forename: M
authors.initials: M
authors.lastname: Kapadvanjwala
authors.forename: G N
authors.initials: GN
authors.lastname: Sfakianakis
authors.forename: G A
authors.initials: GA
authors.lastname: Kaiser
mesh_terms: D000818:Animals; D001672:Biocompatible Materials; D001792:Blood Platelets / Q000502:physiology*; D002315:Cardiopulmonary Bypass / Q000295:instrumentation*; D005260:Female; D006493:Heparin; D016285:Iloprost / Q000627:therapeutic use*; D007205:Indium Radioisotopes; D010976:Platelet Count; D013552:Swine; D013927:Thrombosis / Q000517:prevention & control*; D013997:Time Factors; D014334:Tropolone
chemical_list: D001672:Biocompatible Materials; D007205:Indium Radioisotopes; D014334:Tropolone; D006493:Heparin; D016285:Iloprost