[Evaluation of nitroglycerin and prostaglandin E1 administration during cardiac surgery]

Twenty patients, subjected to open heart surgery using standard moderate hypothermic and nonpulsatile extracorporeal circulation (ECC), were divided into two groups. In the control group only nitroglycerin was administered for the control of peripheral arterial blood pressure during ECC. In the PGE1 group, prostaglandin E1 (10 ng/kg/min) and nitroglycerin were used simultaneously. Plasma renin activity (PRA), angiotensin I (A I) and II (A II), aldosterone (Ald), epinephrine (E) and norepinephrine (NE) were increased to equal levels in both groups. PRA, A I, A II, and Ald increased five-fold from the initial value during ECC, while E and NE increased twenty-fold. Total peripheral vascular resistance was high in both groups, but the deviation from the normal level was significantly lower in the PGE1 group. Oxygen consumption during ECC revealed similar patterns of change in both groups. Peripheral arterial blood pressure was more easily controlled at acceptable levels in the PGE1 group. We concluded that the administration of both nitroglycerin and prostaglandin E1 may sustain satisfactory peripheral circulation during ECC.