Prostaglandin synthesis inhibitor prevents hypotension without impairing gut perfusion during normothermic cardiopulmonary bypass.
Aortic pressure declines during cardiopulmonary bypass (CPB), particularly at normothermia. It has been reported that administering vasoconstrictors during normothermic CPB (NCPB) to restore perfusion pressure might induce hypoperfusion of splanchnic organs. We have reported that prostaglandin (PG), metabolized in the lung but increased during CPB, might have played a substantial role in hypotension, and that a PG synthesis inhibitor (PGSI) could improve hypotension during CPB. This study was designed to examine whether regional perfusion of splanchnic organs was reduced when PGSI restored systemic perfusion pressure during NCPB. NCPB was performed in eight adult goats for 60 minutes (body weight 57.0 +/- 5.9 kg). PGSI was administered in group P (n = 4), while norepinephrine was administered in group C (n = 4), to keep aortic pressure in the range of 50 to 80 mm Hg. The total systemic flow was maintained at approximately 70 ml/kg/min. Tissue blood flow was measured by means of the colored microsphere method before and 30 and 60 minutes after the start of CPB. In group P, gut blood flows after the start of CPB were higher than those before CPB, significantly in the stomach and jejunum at 30 minutes (p < 0.05), whereas gut blood flows in group C were decreased or not changed. In conclusion, PGSI prevents hypotension without impairing gut perfusion during NCPB.
Sato
Koichi
K
Department of Artificial Organs, National Cardiovascular Center Research Institute, Suita, Osaka, Japan.
Takewa
Yoshiaki
Y
Taenaka
Yoshiyuki
Y
Tatsumi
Eisuke
E
Nishinaka
Tomohiro
T
Shioya
Kyoko
K
Fukuda
Toshihide
T
Ohnishi
Hiroyuki
H
Oshikawa
Mitsuo
M
Uesho
Kunihiro
K
Takano
Hisateru
H
Hayashi
Jun-ichi
J
D000818:Animals; D001794:Blood Pressure; D001831:Body Temperature; D002315:Cardiopulmonary Bypass / Q000379:methods*; D016861:Cyclooxygenase Inhibitors / Q000494:pharmacology*; D005480:Flurbiprofen / Q000494:pharmacology*; D006041:Goats; D007022:Hypotension / Q000517:prevention & control*; D007583:Jejunum / Q000098:blood supply; D008168:Lung / Q000378:metabolism; D008863:Microspheres; D009638:Norepinephrine / Q000494:pharmacology; D010100:Oxygen / Q000378:metabolism; D011453:Prostaglandins / Q000096:biosynthesis*; D013152:Splanchnic Circulation; D013270:Stomach / Q000098:blood supply; D014662:Vasoconstrictor Agents / Q000494:pharmacology
D016861:Cyclooxygenase Inhibitors; D011453:Prostaglandins; D014662:Vasoconstrictor Agents; D005480:Flurbiprofen; D010100:Oxygen; D009638:Norepinephrine