Palatianos G M, Dewanjee M K, Smith W, Novak S, Hsu L C, Kapadvanjwala M, Sfakianakis G N, Kaiser G A
Division of Thoracic and Cardiovascular Surgery, University of Miami School of Medicine, Florida 33101.
ASAIO Trans. 1991 Oct-Dec;37(4):620-2.
To test the hypothesis that temporary platelet inhibition during cardiopulmonary bypass (CPB) with surface heparinized systems may result in platelet preservation, nine Yorkshire pigs were placed on CPB for 3 hours. Platelet labeling was done in all pigs with Indium-111 tropolone. CPB was instituted with a roller pump, a hollow fiber membrane oxygenator (Bentley CM-50 [Baxter-Bentley Laboratories, Irvine, CA]), and an arterial filter. The extracorporeal perfusion systems were surface-coated with the Duraflo-II heparin complex. Group A pigs (n = 5) were systemically heparinized (activated coagulation time longer than 400 sec). Group B pigs (n = 4) were placed on CPB without systematic heparinization, but have received the stable prostacyclin-analog Iloprost (ZK36374) at 1 ng/kg/min i.v. from 30 min before and during CPB. Platelet counts declined in group A pigs at 5 min, 1 hr, 2 hr, and 3 hr of CPB to 79.8% (mean), 66.5%, 71.3%, and 69.0% of pre-CPB values, respectively (p less than 0.05). In group B pigs, mean platelet count during CPB was higher than 90% of control value. Percentage of injected radioactivity detected in the oxygenator was 2.82% in group A pigs versus 0.73% in group B pigs (p = 0.0541). Surface heparinization with the Duraflo II heparin coating complex in combination with Iloprost-induced temporary platelet inhibition resulted in platelet count preservation during CPB in the pig model.
为了验证使用表面肝素化系统在体外循环（CPB）期间进行临时血小板抑制可能会导致血小板保存的假说，将9只约克夏猪进行3小时的CPB。所有猪均用铟-111托酚酮进行血小板标记。使用滚压泵、中空纤维膜氧合器（Bentley CM-50 [百特-本特利实验室，加利福尼亚州欧文市]）和动脉滤器建立CPB。体外灌注系统用Duraflo-II肝素复合物进行表面涂层。A组猪（n = 5）进行全身肝素化（活化凝血时间超过400秒）。B组猪（n = 4）在未进行系统性肝素化的情况下进行CPB，但在CPB前30分钟及CPB期间以1 ng/kg/min的静脉注射速率接受稳定的前列环素类似物伊洛前列素（ZK36374）。A组猪在CPB的5分钟、1小时、2小时和3小时时血小板计数分别降至CPB前值的79.8%（平均值）、66.5%、71.3%和69.0%（p < 0.05）。在B组猪中，CPB期间的平均血小板计数高于对照值的90%。A组猪在氧合器中检测到的注入放射性百分比为2.82%，而B组猪为0.73%（p = 0.0541）。在猪模型中，使用Duraflo II肝素涂层复合物进行表面肝素化并联合伊洛前列素诱导的临时血小板抑制可在CPB期间保持血小板计数。
