Issue |
J Extra Corpor Technol
Volume 19, Number 3, September 1987
|
|
---|---|---|
Page(s) | 258 - 264 | |
DOI | https://doi.org/10.1051/ject/1987193258 | |
Published online | 29 August 2023 |
Original Article
Preservation of Canine Platelets with Iloprost (ZK 36374) during Extracorporeal Circulation
Department of Surgery, Division of Cardiothoracic Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
* Direct communications to: Dr. V. Paul Addonizio, University of Pennsylvania School of Medicine, Harrison Department of Surgical Research, 313 Medical Education Building, 36th & Hamilton Walk, Philadelphia, PA 19104
(J. Extra-Corpor. Technol. 19[3] p. 258-264 Fall 1987, 23 ref.) Contact between blood and synthetic/air interfaces during extracorporeal circulation (ECC) results in adverse platelet alterations. We tested the efficacy of a new reversible potent prostacyclin analogue, iloprost (ZK 36374), in preventing these untoward conseguences in fifteen mongrel dogs undergoing extracorporeal circulation using either a membrane or bubble oxygenator. In treated groups, infusion of iloprost was incrementally increased to 150 ng/kg/min at least 15 minutes prior to incision. Equal infusion volumes of saline were administered to the control group. Platelet counts in control dogs (n = 6, membrane/control) decreased to 57 ± 10% (mean ± standard error of the mean) of initial levels by 30 minutes of ECC; in contrast, dogs infused with iloprost demonstrated consistently stable platelet counts despite perfusion with either membrane (1 07 ± 1 0%, n = 6) or bubble (81 ± 13%, n = 3) oxygenators. At 30 minutes of ECC, the iloprost infusion was discontinued. Although the platelet counts in the membrane iloprost-treated group continued to remain stable (99 ± 7%), platelet counts in the bubble iloprost-treated group droppped precipitously to 49 ± 1 0% within 60 minutesof discontinuance of infusion. Furthermore, by 90 minutes of ECC, platelets continued to demonstrate reduced sensitivity to ADP as measured by percent light transmission in both control (53 ± 15%) and bubble iloprost-treated (20 ± 16%) groups. In contrast, the membrane iloprost-treated group regained normal reactivity (80 ± 15%). We conclude that iloprost effectively prevents adverse platelet alterations during ECC. Furthermore, its salutary effects in membrane oxygenator systems persist long after platelet functional inhibition is reversed.
Key words: blood trauma / iloprost / oxygenator / bubble / oxygenator / comparison / oxygenator / membrane / platelet / adhesion
© 1987 AMSECT
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