Prostaglandin E-1 does not influence plasmatic coagulation, hepatic synthesis, or postoperative blood loss in patients after coronary-artery bypass grafting

Study Objective: To assess whether postoperatively administered prostagland in E-1 (PGE(1)) might prevent bleeding in patients after coronary artery by pass grafting (CABG). Design: Prospective, randomized, placebo-controlled trial. Setting: University-affiliated hospital. Patients: 49 patients scheduled for elective CABG surgery. Interventions: The PGE(1) group received intravenous PGE(1) 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 PGE(1) group vs. 5 i n 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 diffe rence between the groups concerning the amount of packed red blood cells, p latelet concentrates, or fresh frozen plasma transfused No significant diff erences could be observed regarding laboratory markers of coagulation activ ation or hepatic synthesis either. Conclusions: PGE(1) did 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 administra tion of acetylsalicylic acid, whose antiaggregatory activity seems to excee d the effects of PGE(1). (C) 2000 by Elsevier Science Inc.