Prostaglandin synthesis inhibitor improves hypotension during normothermic cardiopulmonary bypass.
Hypotension is a major systemic side effect during cardiopu monary bypass (CPB), especially at normothermia. We previously reported that prostaglandin (PG) might play a substantial role in hypotension. The purpose of this study was to clarify whether a PG synthesis inhibitor (PGSI) could improve hypotension during CPB. Thirty-six patients undergoing cardiac surgery with normothermic CPB (35-37 degrees C) were divided into two groups: a PGSI group (n = 18), whose members wer given a PGSI before and during CPB, and a control group (n = 18). In both groups, perfusion flow was sufficient and pressure was maintained at above 45 mm Hg by infusion of metaraminol, a vasoconstrictor. The mean arterial pressure throughout CPB was significantly higher in the PGSI group than in the control group (57 +/- 4 vs. 48 +/- 3 mm Hg, p < 0.01), whereas the dose of infused metaraminol was significantly lower in the PGSI group (13 +/- 7 vs. 21 +/- 6 mg, p < 0.01). The blood base excess was not significantly different (1.0 +/- 1.6 vs. 1.7 +/- 1.9 mmol/L, p = 0.28), and urine output was significantly higher in the PGSI group (503 +/- 179 vs. 354 +/- 112 ml/hr, p < 0.01). In conclusion, PGSI can improve hypotension during CPB and increase urine output without impairing peripheral circulation.
Takewa
Y
Y
Department of Artificial Organs, National Cardiovascular Center Research Institute, Suita, Osaka, Japan.
Seki
T
T
Tatsumi
E
E
Taenaka
Y
Y
Takano
H
H
D000368:Aged; D001794:Blood Pressure; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000601:surgery; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage*; D005260:Female; D005480:Flurbiprofen / Q000008:administration & dosage*; D006801:Humans; D007022:Hypotension / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008680:Metaraminol / Q000008:administration & dosage; D008875:Middle Aged; D011446:Prospective Studies; D014556:Urine; D014655:Vascular Resistance; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
D016861:Cyclooxygenase Inhibitors; D014662:Vasoconstrictor Agents; D005480:Flurbiprofen; D008680:Metaraminol