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Thorac Cardiovasc Surg 1981; 29(1): 55-59
DOI: 10.1055/s-2007-1023442
© Georg Thieme Verlag Stuttgart · New York

Hemodynamic Side Effects of Prostaglandin E1 in Patients before and during Cardiopulmonary Bypass

G. Karliczek, J. J. A. M. van den Dungen, U. Brenken, L. Eijsman, G. J. Kootstra, J. N. Homan van der Heide, Ch. R. H. Wildevuur
  • Departments of Anesthesiology, Cardiopulmonary Surgery, and Experimental Surgery, University Hospital, State University, Groningen, The Netherlands
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Publication History

Publication Date:
19 March 2008 (online)

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Summary

Animal experiments have shown that the administration of prostaglandin E1 (PGE1) during cardiopulmonary bypass (CPB) reduces platelet damage and the tendency to bleeding disorders.

Because PGE1 also has a strong vasodilating action, a clinical trial was started to evaluate its hemodynamic side-effects. PGE1 was studied during 3 different periods:

  1. a 10-minute period before bypass,

  2. a hemodynamically stable period during CPB,

  3. during the whole period of CPB.

1. Before CPB, a consistent fall of mean arterial pressure (MAP) was observed (26 mmHg). 2. During the stable period of CPB, the blood pressure fall was dependent on the pre-existing systemic vascular resistance. 3. PGE1 infusion during the whole CPB period was, in general, badly tolerated. Increased perfusion flow was not sufficient to compensate for the resulting blood pressure drop. In most of the 13 cases vasopressors had to be given continuously. In 7 patients PGE1 had to be reduced, and in 4 patients the infusion had to be stopped altogether.

Because of the marked vasodilator effects of PGE1 it appears impossible to give patients doses adequate to achieve platelet preservation during clinical CPB with safety.

Key words

Open heart surgery - Prostaglandin - PGE1 - Hemodynamic

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