Effects of Alprostadil Infusion During Extracorporeal Circulation on Blood Rheology and Postoperative Blood Loss

Abstract

The authors have investigated the effects a low dose of alprostadil (synthetic prostaglandin E₁: S-PGI₁) infusion during cardiac surgery on blood rheology and postoperative blood loss. S-PGE₁ (20 ng/kg/minute) was given to 13 patients undergoing aortocoronary bypass. Another 13 patients who received no S-PGE₁ during bypass surgery served as controls. To assess blood rheology, blood samples for red and white cell filterability (RFR and WFR) and for platelet count were collected preoperatively, immediately after the end of extracorporeal circulation (ECC), and twenty-four hours later. Records of blood loss were taken twelve and twenty-four hours postoperatively. RFR, WFR, and platelet counts at twenty-four hours were significantly reduced in the control group as compared with the S-PGE₁ group, p = 0.002, p = 0.004, and p = 0.0026, respectively. Concomitantly, the means of the postoperative blood loss at twelve and twenty-four hours were lower in the S-PGE₁ group, p= 0.0001 and p=0.0004, respectively. Furthermore, the use of blood transfusion products was significantly less in the S-PGE, group, p < 0.02. These results showed that the use of S-PGE, during ECC preserves blood rheology in association with significant reductions in blood loss and in the need for blood transfusion postoperatively.