Combined administration of nitric oxide gas and iloprost during cardiopulmonary bypass reduces platelet dysfunction: A pilot clinical study

Abstract

Nitric oxide plus iloprost reduced the deleterious effects of cardiopulmonary bypass, such as thrombocytopenia, platelet activation, platelet-leukocyte aggregate formation, and suppression of platelet aggregative responses. The reduced postoperative bleeding observed with this treatment suggests that this is a new and clinically feasible therapeutic option for patients subjected to cardiopulmonary bypass.

Phosphorylcholine-Coated Circuits Improve Preservation of Platelet Count and Reduce Expression of Proinflammatory Cytokines in CABG: A Prospective Randomized Trial

“…Such concepts would include the combined use of pharmacological interventions (e.g., aprotinin, tranexamic acid, steroids, nitric oxide gas, and iloprost) with the use of coated bypass circuits (e.g., phosphorylcholine and heparin), and modified surgical techniques to reduce blood cell activation (e.g., cell saver use for cardiotomy suction). In a recent clinical trial investigating the efficacy of low‐dose gaseous nitric oxide applied directly to the membrane oxygenator in patients undergoing coronary artery bypass surgery, we were able to attenuate CPB‐induced thrombocytopenia and expression of markers of platelet activation 19 . This resulted in a significant reduction in postoperative blood loss.…”

Platelet Activation during Haemodialysis: Comparison of Cuprammonium Rayon and Polysulfone Membranes

“…Indeed, there are reports on animal experiments investigating this concept by using extracorporeal circuits coated with nitric oxide releasing polymers [21] . There is a preliminary report on nitric oxide attenuated platelet activation in extracorporeal bypass surgery in humans [22] .…”

The Nanopharmacology and Nanotoxicology of Nanomaterials: New Opportunities and Challenges

“…1. A) The general design and functionalization of multifunctional magnetic nanoparticles: a magnetic core capable of scattering or absorption of an interacting electromagnetic field, allowing diagnostics and treatment; a pharmaceutical load for selective delivery of therapeutics; antibodies that target specific cellular markers, and biocompatibility with polyethylene glycol (PEG), allowing a longer half-life of nanoparticles in the bloodstream [13,43,54] B) A proposed design for multifunctional ferromagnetic nanoparticles for the treatment of Kasabach-Merrit disease: a ferromagnetic core using ferric oxide; a pharmaceutical load with a chemotherapeutic agent [25] a nitric oxide (NO)/barbiturate hybrid, a strong inhibitor of cancer-cell proliferation and secretion [142], and iloprost, an analog of prostacyclin, a potent inhibitor of platelet aggregation that synergizes with NO [143]; targeting hemangioma cells using antibodies against vascular endothelial growth factor receptors [144] and an EM field; and a coating providing biocompatibility with PEG gadolinium-based contrasts and dynamic contrast enhanced magnetic resonance imaging) and treatment of atherosclerotic plaques [20,21]. The European Union actively supports projects related to the use of nanomedicine to combat atherosclerosis.…”