title: Disadvantages of prostacyclin infusion during cardiopulmonary bypass: a double-blind study of 50 patients having coronary revascularization.
abstract: Prostacyclin (PGI2) 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 PGI2, 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 PGI2 (76 +/- 2 mm Hg to 53 +/- 2 mm Hg; p less than 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 X 10(3) versus 130 +/- 8 X 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 (PGI2 group) (NS); 18 of the patients given PGI2 required 26 transfusions compared with 16 transfusions in 8 of the patients given a placebo (p less than 0.05). In PGI2 patients, arterial oxygen tension on 100% oxygen fell from 281 +/- 18 mm Hg before CPB to 223 +/- 17 mm Hg immediately after CPB (p less than 0.05). The placebo patients did not show a change in this variable.(ABSTRACT TRUNCATED AT 250 WORDS)
mesh_terms: D015121:6-Ketoprostaglandin F1 alpha / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects; D001803:Blood Transfusion; D002315:Cardiopulmonary Bypass; D002986:Clinical Trials as Topic; D001026:Coronary Artery Bypass; D004311:Double-Blind Method; D011464:Epoprostenol / Q000008:administration & dosage* / Q000494:pharmacology; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010976:Platelet Count; D011897:Random Allocation; D013929:Thromboxane B2 / Q000097:blood; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
chemical_list: D014662:Vasoconstrictor Agents; D013929:Thromboxane B2; D015121:6-Ketoprostaglandin F1 alpha; D006493:Heparin; D011464:Epoprostenol; D010100:Oxygen