title: Nitroglycerin and sodium nitroprusside: potential contributors to postoperative bleeding?
abstract: Postoperative bleeding is common in patients undergoing cardiac surgery with cardiopulmonary bypass. Most cases of severe postoperative bleeding not due to incomplete surgical hemostasis are related to acquired transient platelet dysfunction mediated by platelet activation during contact with the synthetic surfaces of the cardiopulmonary bypass equipment. Antihypertensive agents nitroglycerin and sodium nitroprusside have been shown to have platelet inhibitory properties, yet the clinical consequence in terms of postoperative bleeding has been little studied. Knowing that cardiopulmonary bypass causes platelet dysfunction, it is prudent for physicians to be aware of the additional platelet inhibition caused by these commonly used antihypertensive agents.
authors.affiliation: Department of Medicine, Division of Internal Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Donald
authors.initials: D
authors.lastname: Clark
authors.forename: Stephanie
authors.initials: S
authors.lastname: Tesseneer
authors.forename: Curtis G
authors.initials: CG
authors.lastname: Tribble
mesh_terms: D000959:Antihypertensive Agents / Q000009:adverse effects; D005260:Female; D006801:Humans; D006973:Hypertension / Q000517:prevention & control; D008297:Male; D005996:Nitroglycerin / Q000009:adverse effects*; D009599:Nitroprusside / Q000009:adverse effects* / Q000627:therapeutic use; D019106:Postoperative Hemorrhage / Q000139:chemically induced* / Q000517:prevention & control*; D011292:Premedication / Q000009:adverse effects*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000009:adverse effects
chemical_list: D000959:Antihypertensive Agents; D014665:Vasodilator Agents; D009599:Nitroprusside; D005996:Nitroglycerin