Disadvantages of prostacyclin infusion during cardiopulmonary bypass: a double-blind study of 50 patients having coronary revascularization
| Autor: | Lelcuk S, Lawrence H. Cohn, John J. Collins, William V. Huval, Richard J. Shemin, Rosemarie Maddi, Herbert B. Hechtman, Richard A. Jonas, Verdi J. DiSesa, Stanley Leeson |
|---|---|
| Rok vydání: | 1984 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male Mean arterial pressure Prostacyclin Blood Pressure 6-Ketoprostaglandin F1 alpha Placebo law.invention Bubble oxygenator Random Allocation Double-Blind Method law Cardiopulmonary bypass Medicine Humans Vasoconstrictor Agents Blood Transfusion Infusions Parenteral Coronary Artery Bypass Clinical Trials as Topic Cardiopulmonary Bypass business.industry Heparin Platelet Count Middle Aged Epoprostenol Oxygen Thromboxane B2 surgical procedures operative medicine.anatomical_structure Anesthesia Surgery Female Cardiology and Cardiovascular Medicine business Perfusion medicine.drug Artery |
| Zdroj: | The Annals of thoracic surgery. 38(5) |
| ISSN: | 0003-4975 |
| Popis: | Prostacyclin (PGI 2 ) has been suggested for use in cardiopulmonary bypass (CPB) because of its positive effects on platelet number and function. Fifty patients who underwent coronary artery bypass grafting using a bubble oxygenator received heparin, 3 mg per kilogram of body weight, and then were randomly assigned to receive PGI 2 , 25 ng/kg/min, beginning 5 minutes before and until the end of CPB (26 patients) or a placebo (24 patients). Both groups were similar in sex, age, heparin dose, protamine dose, and CPB time. During CPB, mean arterial pressure fell significantly with PGI 2 (76 ± 2 mm Hg to 53 ± 2 mm Hg; p 3 versus 130 ± 8 × 10 3 ; not significant [NS]) and were unchanged 3 hours after CPB. Total chest tube output was 647 ± 51 ml (placebo group) versus 576 ± 34 ml (PGI 2 group) (NS); 18 of the patients given PGI 2 required 26 transfusions compared with 16 transfusions in 8 of the patients given a placebo ( p 2 patients, arterial oxygen tension on 100% oxygen fell from 281 ± 18 mm Hg before CPB to 223 ± 17 mm Hg immediately after CPB ( p 2 (TXB 2 ) from 150 ± 30 to 360 ± 60 pg/ml ( p 2 patients but it was not significantly increased in the placebo group (180 ± 30 to 270 ± 40 pg/ml; NS). At 25 ng/kg/min, PGI 2 has no demonstrable beneficial effect on platelet count or postoperative bleeding in patients having elective cardiac operations. Deleterious effects on mean arterial pressure, arterial oxygen tension, and TXB 2 levels during and after CPB are associated with administration of PGI 2 at this dosage. |
| Databáze: | OpenAIRE |
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