Study Objective: To examine the effects of small doses of prostaglandin E-1
(PGE(1)) on systemic hemodynamics and cerebral oxygenation during cardiopu
Design: Randomized, prospective study.
Setting: Cardiac surgery at Saitama Cardiovascular and Pulmonary Center.
Patients: Forty patients who underwent elective coronary artery bypass surg
Interventions : The study was performed at the stable CPB period. Patients
were randomly divided into four groups: control group (n = 10) received an
infusion of saline, PGE(1) 10 group (n = 10) received an infusion of PGE(1)
10 ng/kg/min, PGE(1) 25 group (n = 10) received an infusion of PGEI 25 ng/
kg/min, and the PGE(1) 50 group (n = 10) received an infusion of PGEI 50 ng
Measurements: After measuring the baseline partial Pressure of the arterial
oxygen saturation (SpO(2)), mixed venous oxygen saturation (SvO(2)), and j
ugular venous oxygen saturation (SjvO(2)), blood gases, and cardiovascular
hemodynamic values, PGEI was infused intravenously at rate of between 10 an
d 50 ng/kg/min. PGE(1) infusion continued 30 minutes after the start of dru
g infusion, and the blood gas analysis and cardiovascular hemodynamic value
s were simultaneously determined together with the hemodynamic values at 2,
5, 10, 20, and 30 minutes during drug infusion. At 30 minutes after discon
tinuation of the drug infusion, the blood gas analyses were simultaneously
determined together with the hemodynamic values. Main
Results: Mean arterial pressure (MAP) in PGEI 25 and 50 groups was decrease
d 20 and 30 minutes after the start of PGEI infusion compared with the base
line value (p < 0.05). In contrast, SvO(2) in PGEI 25 and 50 groups was inc
reased 20 and 30 minutes after the start of PGE, infusion compared with the
baseline value (p < 0.05). There was no change in SjO(2) value despite a d
ecrease in MAP during the study.
Conclusions: Cerebral oxygenation estimated by SjvO(2) was maintained despi
te a decrease in MAP during the administration rate of PGE(1) between 10 an
d 50 ng/kg/min. (C) 2001 by Elsevier Science Inc.