Investigation on Improvement of Peripheral Circulation by Continuous Use of Prostaglandin E1 during Open Heart Surgery. Evaluation with Peripheral Blood Flow by Laser Doppler Flowmeter and Temperature Difference between the Periphery and Core.
10.4326/jjcvs.22.462
- VernacularTitle:開心術中のｐｒｏｓｔａｇｌａｎｄｉｎ Ｅ１持続使用による末梢循環改善効果 主にｌａｓｅｒ Ｄｏｐｐｌｅｒ組織血流計による足し血流と末梢中枢温度較差を指標として
- Author:
Yuji HIRAMATSU
;
Yuzuru SAKAKIBARA
;
Naotaka ATSUMI
;
Tomoaki JIKUYA
;
Tatsuo TSUTSUI
;
Kenji OKAMURA
;
Toshio MITSUI
;
Motokazu HORI
;
Akira SAKAI
;
Mikio OHSAWA
- Publication Type:Journal Article
- Keywords:
prostaglandin E1
- From:Japanese Journal of Cardiovascular Surgery
1993;22(6):462-467
- CountryJapan
- Language:Japanese
-
Abstract:
Prostaglandin E1 (PGE1) was used continuously in adults from immediately after induction of anesthesia, during extracorporeal circulation, to the acute phase after open heart surgery. Using blood flow in the toe determined by laser Doppler flowmeter and the temperature difference between periphery and core as indices, the effects of afterload reduction and improvement of peripheral circulation were investigated. Subjects were 17 adults who underwent open heart surgery. PGE1 was used in 7 patients and not used in 10. In the group using PGE1, continuous injection of 0.015μg/kg/min of PGE1 was started immediately after induction of anesthesia and was maintained during extracorporeal circulation until the acute phase after surgery. During extracorporeal circulation, perfusion pressure was kept at 50∼60mmHg and PGE1 injection was controlled within the range of 0.015∼0.030μg/kg/min. At completion of extracorporeal circulation, the dose was fixed at 0.015μg/kg/min again. The degree of improvement of peripheral circulation was evaluated on the basis of hemodynamics, blood flow in the toe determined by laser Doppler flowmeter and the temperature difference between periphery and core, at induction of anesthesia (before using PGE1) on completion of extracorporeal circulation, and in the acute phase after surgery. The value of blood flow in the toe determined by laser Doppler flowmeter was significantly higher in the PGE1 group than in the non-PGE1 group, from completion of extracorporeal circulation to the acute phase after surgery. Moreover, peripheral temperature was significantly higher in the PGE1 group than in the non-PGE1 group at completion of the extracorporeal circulation as well as immediately after surgery, and the temperature difference between periphery and core was significantly smaller. Continuous injection of PGE1 enabled smooth control of perfusion pressure during extracorporeal circulation. Although there was no significant difference in peripheral vascular and total pulmonary resistance, the coefficients tended to be lower in the PGE1 group. The use of PGE1 during open heart surgery seems to be an effective method to improve peripheral circulation.
