Abstract
Free radicals produced during cardiopulmonary bypass (CPB) stimulate lipid peroxidation reactions in the living cells. The blood cells are particularly vulnerable due to trauma of CPB which reduce their rheological function, thereby affecting the microcirculation in the body. The effects of Alprostadil (Synthetic Prostaglandin E1: S-PGE1) during CPB on lipid peroxidation caused by oxygen free radical (OFR) production and blood cell rheology were studied. The plasma malondialdehyde (MDA) was used as a marker for lipid peroxidation reactions. Red cell flltration rate (RFR) and white cell filtration rate (WFR) were measured as indices of blood cell rheology. Twenty four patients were studied, 12 received PGE1 infusion (20 ng/kg/min) intraoperatively and 12 served as controls. RFR, WFR and MDA were measured before the start of CPB, after release of the aortic cross clamp and at the end of CPB. The production of MDA was significantly lower in the PGE1 group when compared to the controls (P<0.00l). Concomitantly, RFR and WFR in the PGE1 group were kept near to the prebypass values while both values reduced markedly in the control group (P<0.00l). These results indicated that the beneficial effect of PGE1 on RFR and WFR may be related to an inhibitory action of PGE1 on the release of free radicals during CPB as well as having a cellular protective action against OFR injury. The preservation of blood rheology and the limitation of OFR generation during CPB is advantageous to the vital organs.
Get full access to this article
View all access options for this article.