Prostaglandin E₁ does not influence plasmatic coagulation, hepatic synthesis, or postoperative blood loss in patients after coronary-artery bypass grafting - 04/09/11

Doi : 10.1016/S0952-8180(00)00170-7

Gottfried J Locker, MD ^a,^{Staff Physician}, ⁎, Michael Grimm, MD ^b,^{†
Associate Professor of Surgery}, Heidrun Losert, MD ^a,^{Staff Physician}, Brigitte Stoiser, MD ^a,^{Staff Physician}, Julia Kofler, MD ^a,^{Staff Physician}, Sylvia Knapp, MD ^a,^{Staff Physician}, Astrid Wilfing, MD ^a,^{Staff Physician}, Paul Knoebl, MD ^c,^{‡
Associate Professor of Internal Medicine}, Stylianos Kapiotis, MD ^d,^{§
Associate Professor of Medical and Chemical Laboratory Diagnostics}, Martin Czerny, MD ^b,^{¶
Staff Surgeon}, Manfred Muhm, MD ^e,^{^{‖
Associate Professor of Anesthesiology}}, Michael Hiesmayr, MD ^e,^{^{‖
Associate Professor of Anesthesiology}}, Michael Frass, MD ^a,^{#
Professor of Internal Medicine}
^a Department of Internal Medicine I, Intensive Care Unit, University Hospital of Vienna, Vienna, Austria
^b Department of Cardiothoracic Surgery, University Hospital of Vienna, Vienna, Austria
^c Department of Internal Medicine I, Division of Hematology and Hemostaseology, University Hospital of Vienna, Vienna, Austria
^d Department of Medical and Chemical Laboratory Diagnostics, University Hospital of Vienna, Vienna, Austria
^e Department of Cardio-Thoracic and Vascular Anesthesia & Intensive Care, University Hospital of Vienna, Vienna, Austria

^*Address correspondence to Dr. Locker at the Department of Internal Medicine I, Intensive Care Unit, University Hospital of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria

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 PGE₁ 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: PGE₁did 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.

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Keywords : Blood loss, coagulation, complications, prostaglandin E₁

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Introduction

Materials and methods

Statistical analysis

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Clinical parameters

Laboratory parameters

Discussion

Supported in part by Grant No. 1544 from the Medizinisch-Wissenschaftlicher Fonds des Buergermeisters der Bundeshauptstadt Wien.

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Vol 12 - N° 5

P. 363-370 - août 2000 Retour au numéro

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Prostaglandin E₁ does not influence plasmatic coagulation, hepatic synthesis, or postoperative blood loss in patients after coronary-artery bypass grafting - 04/09/11

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