A. Gabriel et al., INFLUENCE OF PROSTAGLANDIN E(1) ON TISSUE ISCHEMIA DURING SURGICAL REPAIR OF THE ABDOMINAL-AORTA, Journal of cardiothoracic and vascular anesthesia, 10(2), 1996, pp. 201-206
Citations number
19
Categorie Soggetti
Anesthesiology,"Peripheal Vascular Diseas","Cardiac & Cardiovascular System
Objective: To evaluate tissue protection by PGE(1) during leg ischemia
in patients undergoing aortic surgery. Design: Randomized, controlled
prospective clinical trial. Setting: Single university hospital. Part
icipants: 19 consecutive patients undergoing abdominal aortic aneurysm
repair. Interventions: Patients received infusions of 30 ng/kg/min of
PGE(1) or saline. Measurements and Main Results: Hemodynamic variable
s. lactate, creatine phosphokinase, and thromboxane B-2 (TXB(2)) were
measured. In the control group, the decrease in cardiac index (CI) aft
er aortic cross-clamping (AXC) persisted until unclamping together wit
h a decrease in femoral venous O-2 content (CfvO2). In the PGE(1) grou
p, CI returned to baseline with a trend toward greater CfvO2 levels. D
uring reperfusion in the PGE(1) group, O-2 consumption and lactate lev
els exceeded preclamp values. Pulmonary hypertension occurred equally
in both groups but did not correlate with TXB(2), which was not altere
d by surgery or by PGE(1) infusion. Conclusions: Intraoperative PGE(1)
treatment offers no benefit and may exacerbate tissue ischemia during
AXC by redistributing microcirculatory flow or limiting cellular oxyg
en utilization in a manner that overwhelms any possible protective eff
ect. (C) 1996 by W.B. Saunders Company