Reduction of neutrophil activation by prostaglandin E1 in open heart surgery
Nakazawa, S.
Nihon Kyobu Geka Gakkai 40(7): 1078-1084
1992
ISSN/ISBN: 0369-4739 PMID: 1324281 Document Number: 395451
This study was designed to demonstrate the effect of prostaglandin E-1 (PGE-1) on neutrophil activation in open heart surgery. Twenty adult patients undergoing cardiopulmonary bypass (CPB) for various cardiac operations were divided into 2 groups. PGE-1 group consisted of 10 patients (7 males and 3 females) and the control group consisted of 10 patients (6 males and 4 females). In PGE-1 group patients, 20 apprx 50 ng/kg/min of PGE-1 was administered intravenously from the induction of anesthesia to the completion of CPB. Blood samples were taken before, during, after CPB, and in the morning of the first postoperative day. Differential counts of white blood cells, plasma neutrophil elastase (PNEL) activity, serum complements activity (C3a, CH50) and superoxide production of neutrophils were measured. Superoxide production by isolated neutrophils was evaluated utilizing luminol dependent chemiluminescence. After the initiation of CPB complements were activated markedly, and PNEL activity increased significantly in both groups. Although after CPB PNEL activity turned to decrease, it was still significantly higher on the first postoperative day than he preoperative value. There were no significant differences between two groups as for complements activation and PNEL activity. The total number of white blood cells unchanged during CPB and neutrophils appeared after CPB, but no significant difference between two groups. Superoxide production of neutrophils relatively decreased during CPB and significantly increased after CPB in the control group. However, in PGE-1 group superoxide production was reduced after CPB, especially on the first postoperative day. These results showed that PGE-1 reduced neutrophil-mediated superoxide production in open heart surgery. In conclusions, PGE-1 is useful agent to reduce the hazardous effects of neutrophils after CPB.