Prostaglandin E(1) does not influence plasmatic coagulation, hepatic synthesis, or postoperative blood loss in patients after coronary-artery bypass grafting.

Abstract

STUDY OBJECTIVE:

To assess whether postoperatively administered prostaglandin E1 (PGE1) might prevent bleeding in patients after coronary artery bypass grafting (CABG).

DESIGN:

Prospective, randomized, placebo-controlled trial.

SETTING:

University-affiliated hospital.

PATIENTS:

49 patients scheduled for elective CABG surgery.

INTERVENTIONS:

The PGE1 group received intravenous PGE(1) up to 15 ng/kg/min for 72 hours after surgery, whereas the placebo group received isotonic saline for the same time period.

MEASUREMENTS AND MAIN RESULTS:

Nine patients (4 in the PGE1 group vs. 5 in the placebo group) had to be excluded because of hemodynamic instability, and 1 in the placebo group because of gastric bleeding. In the remaining 39 patients (20 vs. 19), no significant differences with regard to hemoglobin levels or platelet count could be observed. There was no significant difference between the groups concerning the amount of packed red blood cells, platelet concentrates, or fresh frozen plasma transfused. No significant differences could be observed regarding laboratory markers of coagulation activation or hepatic synthesis either.

CONCLUSIONS:

PGE1 did not prevent coagulation disturbances and blood loss when administered postoperatively in patients undergoing CABG. The absence of these expected effects might be explained by the concomitant administration of acetylsalicylic acid, whose antiaggregatory acivity seems to exceed the effects of PGE1.

• Authors: G J Locker, M Grimm, H Losert, B Stoiser, J Kofler, S Knapp, A Wilfing, P Knoebl, S Kapiotis, M Czerny, M Muhm, M Hiesmayr, M Frass
• Journal: Journal of clinical anesthesia (J Clin Anesth) Vol. 12 Issue 5 Pg. 363-70 (Aug 2000) ISSN: 0952-8180 [Print] United States
• PMID: 11025235 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Alprostadil

Topics

• Aged
• Alprostadil (pharmacology)
• Anesthesia
• Blood Coagulation (drug effects)
• Coronary Artery Bypass
• Critical Care
• Extracorporeal Circulation
• Female
• Humans
• Liver (drug effects, metabolism)
• Male
• Middle Aged
• Postoperative Hemorrhage (blood)
• Prospective Studies