Coppe D, Sobel M, Seamans L, Levine F, Salzman E
J Thorac Cardiovasc Surg. 1981 Feb;81(2):274-8.
Thirty-four dogs underwent total cardiopulmonary bypass for 1 or 2 hours with a bubble oxygenator and cardiotomy suction. The dogs were divided into three groups: control dogs which received heparin alone, dogs which received prostacyclin (PGI2) and heparin, and dogs which received prostacyclin alone. PGI2 was given as a bolus (6 to 60 microgram) and then as a constant infusion (0.2 to 0.8 microgram/kg/min) in the venous outflow line. The pump flows were equal in the three groups. PGI2 as a bolus led to transient hypotension, and 60 microgram reduced cardiac output temporarily. During cardiopulmonary bypass, dogs treated with prostacyclin and heparin had low mean arterial perfusion pressures which responded to fluid infusion or phenylephrine. After 1 hour of cardiopulmonary bypass and reversal with protamine, dogs treated with prostacyclin and heparin had shorter bleeding times (p < 0.02) and better platelet function than control animals. After 2 hours, they had normal platelet number, but only half showed preservation of platelet function. When heparin was omitted, PGI2 preserved platelet number, but consumption coagulopathy developed, with prolonged prothrombin, partial thromboplastin, and bleeding times and decreased fibrinogen levels. PGI 2 preserves platelet number and function but may cause hypotension, and it cannot replace heparin in cardiopulmonary bypass.
34只狗使用鼓泡式氧合器和心内吸引器进行了1或2小时的全心肺转流。这些狗被分为三组：仅接受肝素的对照狗、接受前列环素（PGI2）和肝素的狗以及仅接受前列环素的狗。PGI2先静脉推注（6至60微克），然后在静脉流出道以恒定速率输注（0.2至0.8微克/千克/分钟）。三组的泵流量相等。静脉推注PGI2会导致短暂性低血压，60微克会使心输出量暂时降低。在心肺转流期间，接受前列环素和肝素治疗的狗平均动脉灌注压较低，对液体输注或去氧肾上腺素有反应。在心肺转流1小时并用鱼精蛋白中和后，接受前列环素和肝素治疗的狗出血时间较短（p < 0.02），血小板功能比对照动物更好。2小时后，它们的血小板数量正常，但只有一半的狗血小板功能得以保留。当省略肝素时，PGI2可保留血小板数量，但会发生消耗性凝血病，凝血酶原时间、部分凝血活酶时间和出血时间延长，纤维蛋白原水平降低。PGI2可保留血小板数量和功能，但可能导致低血压，在心肺转流中不能替代肝素。
