title: Influence of prostaglandin E1 on tissue ischemia during surgical repair of the abdominal aorta.
abstract: OBJECTIVE
  To evaluate tissue protection by PGE1 during leg ischemia in patients undergoing aortic surgery.
  
  
  METHODS
  Randomized, controlled prospective clinical trial.
  
  
  METHODS
  Single university hospital.
  
  
  METHODS
  19 consecutive patients undergoing abdominal aortic aneurysm repair.
  
  
  METHODS
  Patients received infusions of 30 ng/kg/min of PGE1 or saline.
  
  
  RESULTS
  Hemodynamic variables, lactate, creatine phosphokinase, and thromboxane B2 (TXB2) were measured. In the control group, the decrease in cardiac index (CI) after aortic cross-clamping (AXC) persisted until unclamping together with a decrease in femoral venous O2 content (CfvO2). In the PGE1 group, CI returned to baseline with a trend toward greater CfvO2 levels. During reperfusion in the PGE1 group, O2 consumption and lactate levels exceeded preclamp values. Pulmonary hypertension occurred equally in both groups but did not correlate with TXB2, which was not altered by surgery or by PGE1 infusion.
  
  
  CONCLUSIONS
  Intraoperative PGE1 treatment offers no benefit and may exacerbate tissue ischemia during AXC by redistributing microcirculatory flow or limiting cellular oxygen utilization in a manner that overwhelms any possible protective effect.
authors.affiliation: Vienna University Medical School, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Gabriel
authors.forename: A
authors.initials: A
authors.lastname: Werba
authors.forename: P
authors.initials: P
authors.lastname: Mares
authors.forename: G
authors.initials: G
authors.lastname: Grubhofer
authors.forename: F
authors.initials: F
authors.lastname: Hrska
authors.forename: A
authors.initials: A
authors.lastname: Griesmacher
authors.forename: G
authors.initials: G
authors.lastname: Kretschmer
authors.forename: F X
authors.initials: FX
authors.lastname: Lackner
authors.forename: N G
authors.initials: NG
authors.lastname: Bircher
authors.forename: S
authors.initials: S
authors.lastname: Schwarz
mesh_terms: D000368:Aged; D000527:Alprostadil / Q000627:therapeutic use*; D001012:Aorta, Abdominal / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007511:Ischemia / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption; D011446:Prospective Studies; D013929:Thromboxane B2 / Q000097:blood
chemical_list: D013929:Thromboxane B2; D000527:Alprostadil; D010100:Oxygen