Effects of Prostacyclin Infusion on Platelet Activation and Postoperative Blood Loss in Coronary Bypass

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

“…Indeed, the beneficial effects of NO and PGI 2 have also been demonstrated in other studies. Aren and associates 22 showed that PGI 2 infusion into the bypass circuit reduced plasma ␤-thromboglobulin levels, reflecting inhibition of platelet activation, although the dosage used (50 ng • kg Ϫ1 • min Ϫ1 ) was much higher than in our study (2 ng • kg Ϫ1 • min Ϫ1 ). Mellgren and colleagues 23 demonstrated higher platelet counts in experimental perfusion circuits treated with NO (15-75 ppm); however, platelet function was not measured in this study.…”

Effect of prostacyclin on vascular capacity in the dog.

“…The finding that PGI2 is the most potent known endogenous inhibitor ofplatelet aggregation suggests its possible use in reducing the deposition ofplatelets and fibrin on the filter mesh in patients undergoing operations with cardiopulmonary bypass (3)(4)(5)(6). As an antiplatelet agent, PGI2 can successfully replace heparin as the sole antithrombic agent in patients with renal failure undergoing hemodialysis (7,8).…”

Elastase Release Following Myocardial Ischemia during Extracorporeal Circulation (ECC) - Marker of Ongoing Systemic Inflammation?

“…Nagaoka [16] reported therapeutic interventions in platelet release reaction during CPB, including the use of antiaggregatory vasodilator prostacyclin [17,18], and use of the platelet activation inhibitor aprotinin [19]. The use of PGl 2 -infusion during CPB remains controversial.…”

“…The use of PGl 2 -infusion during CPB remains controversial. Some investigators [17,18] have suggested that PGl 2 -treated patients had less platelet loss, b-TG, and PF 4 production than those of untreated patients indicating the protective effects of prostacyclin infusion on platelets in open heart surgery. In contrast, others [19] have not only failed to find any beneficial effect of prostacyclin on platelet count or function, but have also found some adverse results.…”