The effect of pentoxifylline on impaired red cell deformability following open-heart surgery.

Red blood cell deformability is essential for a normal nutritional blood flow. The effect of pentoxifylline on impaired red cell deformability following open-heart surgery was studied in 25 patients. The controls were 25 patients with equivalent surgery but no pentoxifylline. After 3 days of preoperative peroral pentoxifylline (1 200 mg/day) there was significant (mean 14%) increase of deformability. Intraoperatively, just before extracorporeal circulation, 300 mg pentoxifylline was given intravenously. During the cardiopulmonary bypass there was nevertheless significant decrease in red cell deformability in the test group (by 29%) as well as in the controls (28%). In the first 2 postoperative days there was further decrease in both groups (31% and 26%). Thereafter, however, deformability improved in the pentoxifylline group but showed additional slight decrease in the controls. By the 6th postoperative day the increase in the test group thus was 35%, whereas the controls showed a further 4% decrease. The reduction in deformability from the preoperative to the 6-day value was significantly less in the pentoxifylline group than in the controls. The study proved that red cell deformability is greatly impaired by extracorporeal circulation. Pre-bypass pentoxifylline medication had a significant prophylactic effect by enhancing the postoperative restitution of deformability.