Disadvantages of prostacyclin infusion during cardiopulmonary bypass: a double-blind study of 50 patients having coronary revascularization.
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)
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
D014662:Vasoconstrictor Agents; D013929:Thromboxane B2; D015121:6-Ketoprostaglandin F1 alpha; D006493:Heparin; D011464:Epoprostenol; D010100:Oxygen