Key result
Prostacyclin administration after cardiopulmonary bypass significantly increased myocardial oxygen consumption compared to controls (18.5 ml vs 13 ml; P<0.01).
Why the study?
Does prostacyclin improve metabolic recovery and reperfusion of the ischaemic myocardium in patients with coronary artery disease undergoing cardiopulmonary bypass?
Does prostacyclin improve metabolic recovery and reperfusion of the ischaemic myocardium in patients with coronary artery disease undergoing cardiopulmonary bypass?
Prostacyclin administration during cardiopulmonary bypass improves metabolic recovery, increases myocardial oxygen consumption, and reduces leukocyte activity during reperfusion.
Answers are grounded in this paper and cite their sources.
Increased post-bypass myocardial oxygen consumption with prostacyclin warrants caution; leaves open net reperfusion benefit in randomized trials.
A total of 20 patients with coronary artery disease were studied in order to assess the benefits of prostacyclin administration on reperfusion of the ischaemic myocardium after cardiopulmonary bypass. Ten received prostacyclin (25 ng/kg per min) while ten were untreated controls. There was no difference between groups with regard to age, preoperative ejection fraction and aortic cross-clamping times. There were no in-hospital deaths in either group. The administration of prostacyclin significantly altered the metabolic side effects of reperfusion followed by hypothermic cardioplegic arrest. Myocardial oxygen consumption after cardiopulmonary bypass was significantly higher in the prostacyclin-treated group than in controls (18.5 ml versus 13 ml; P < 0.01). Prostacyclin treatment significantly reduced the leucocyte activity: leukotriene B4 concentrations were 58 pmol/l in prostacyclin-treated patients compared with 93 pmol/l in controls (P < 0.01). Such recovery of metabolic status during reperfusion resulted in better haemodynamic function in patients receiving prostacyclin.
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S. Katircioglu (1995) studied coronary artery disease (n=20). prostacyclin vs. untreated controls was evaluated on Myocardial oxygen consumption after cardiopulmonary bypass (p=< 0.01). Prostacyclin administration after cardiopulmonary bypass significantly increased myocardial oxygen consumption compared to controls (18.5 ml vs 13 ml; P<0.01).
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