title: Platelet and neutrophil distributions in pump oxygenator circuits. III. Influence of nitric oxide gas infusion.
abstract: The authors used quantitative gamma scintigraphy to evaluate the influence of nitric oxide gas on platelet and neutrophil deposition in Cobe Duo microporous oxygenators during cardiopulmonary bypass (CPB). The effects of nitric oxide gas on circulating platelet and neutrophil counts and platelet function also were assessed. Animals were prepared by standard methods. Cells were harvested, labeled (111 In platelet and 99mTc neutrophil), infused, and recirculated. Nitric oxide gas, a guanylate cyclase pathway promoter, was infused int he Duo gas port at 500 ppm (t = 0-60 min), increased to 1,000 (t = 60-80 min), and stopped (final, 10 min). Images were taken at 10-15 min intervals during CPB. Standard isotope image corrections were made. No differences between nitric oxide gas and control experiments were observed for flow, pressure, hematocrit, or replacement volume. Nitric oxide gas infusion significantly (p < 0.05) reduced both platelet adherence to the oxygenator and in vitro platelet aggregation. Neutrophil adhesion tended to be lower, and circulating platelet and neutrophil counts tended to be higher with nitric oxide gas infusion. Results of in vitro aggregometry studies using rabbit platelets indicate that the class V phosphodiesterase inhibitor zaprinast can strongly enhance the inhibitory effects of nitric oxide. The authors conclude nitric oxide gas is a promising platelet sparing agent in the setting of CPB.
authors.affiliation: University of Texas Southwestern Medical Center at Dallas, Department of Surgery 75235, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Sly
authors.forename: M D
authors.initials: MD
authors.lastname: Prager
authors.forename: J
authors.initials: J
authors.lastname: Li
authors.forename: F B
authors.initials: FB
authors.lastname: Harris
authors.forename: P
authors.initials: P
authors.lastname: Shastri
authors.forename: R
authors.initials: R
authors.lastname: Bhujle
authors.forename: R
authors.initials: R
authors.lastname: Chao
authors.forename: P V
authors.initials: PV
authors.lastname: Kulkarni
authors.forename: A
authors.initials: A
authors.lastname: Constantinescu
authors.forename: M E
authors.initials: ME
authors.lastname: Jessen
authors.forename: R C
authors.initials: RC
authors.lastname: Eberhart
mesh_terms: D000818:Animals; D001792:Blood Platelets / Q000187:drug effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000295:instrumentation; D002448:Cell Adhesion / Q000187:drug effects; D015902:Gamma Cameras; D066298:In Vitro Techniques; D007205:Indium Radioisotopes; D007958:Leukocyte Count; D008297:Male; D009504:Neutrophils / Q000187:drug effects*; D009569:Nitric Oxide / Q000008:administration & dosage*; D010107:Oxygenators, Membrane / Q000009:adverse effects; D010726:Phosphodiesterase Inhibitors / Q000494:pharmacology; D010973:Platelet Adhesiveness / Q000187:drug effects; D010974:Platelet Aggregation / Q000187:drug effects; D010976:Platelet Count; D011688:Purinones / Q000494:pharmacology; D011817:Rabbits; D013552:Swine; D013667:Technetium
chemical_list: D007205:Indium Radioisotopes; D010726:Phosphodiesterase Inhibitors; D011688:Purinones; D009569:Nitric Oxide; D013667:Technetium; C011145:zaprinast