Prostaglandin E(1) does not influence plasmatic coagulation, hepatic synthesis, or postoperative blood loss in patients after coronary-artery bypass grafting.
OBJECTIVE
To assess whether postoperatively administered prostaglandin E1 (PGE1) might prevent bleeding in patients after coronary artery bypass grafting (CABG).


METHODS
Prospective, randomized, placebo-controlled trial.


METHODS
University-affiliated hospital.


METHODS
49 patients scheduled for elective CABG surgery.


METHODS
The PGE1 group received intravenous PGE(1) up to 15 ng/kg/min for 72 hours after surgery, whereas the placebo group received isotonic saline for the same time period.


RESULTS
Nine patients (4 in the PGE1 group vs. 5 in the placebo group) had to be excluded because of hemodynamic instability, and 1 in the placebo group because of gastric bleeding. In the remaining 39 patients (20 vs. 19), no significant differences with regard to hemoglobin levels or platelet count could be observed. There was no significant difference between the groups concerning the amount of packed red blood cells, platelet concentrates, or fresh frozen plasma transfused. No significant differences could be observed regarding laboratory markers of coagulation activation or hepatic synthesis either.


CONCLUSIONS
PGE1 did not prevent coagulation disturbances and blood loss when administered postoperatively in patients undergoing CABG. The absence of these expected effects might be explained by the concomitant administration of acetylsalicylic acid, whose antiaggregatory acivity seems to exceed the effects of PGE1.
Locker
G J
GJ
Department of Internal Medicine I, Intensive Care Unit, University Hospital of Vienna, Vienna, Austria.
Grimm
M
M
Losert
H
H
Stoiser
B
B
Kofler
J
J
Knapp
S
S
Wilfing
A
A
Knoebl
P
P
Kapiotis
S
S
Czerny
M
M
Muhm
M
M
Hiesmayr
M
M
Frass
M
M
D000368:Aged; D000527:Alprostadil / Q000494:pharmacology*; D000758:Anesthesia; D001777:Blood Coagulation / Q000187:drug effects*; D001026:Coronary Artery Bypass; D003422:Critical Care; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D008099:Liver / Q000187:drug effects / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000097:blood*; D011446:Prospective Studies
D000527:Alprostadil