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Preservación de las plaquetas y su función en el bypass cardiopulmonar prolongado utilizando prostaciclina
Circulation
|August 1, 1981
Resumen
La prostaciclina (PGI2) combinada con dosis bajas de heparina previene eficazmente la formación de coágulos durante el bypass cardiopulmonar en perros. Esta combinación preserva la función plaquetaria y reduce el sangrado, ofreciendo una alternativa más segura para la anticoagulación.
Área de la Ciencia:
- Cirugía cardiovascular La cirugía cardiovascular es una cirugía cardiovascular.
- Farmacología Farmacología.
- Hematología Hematología.
Sus antecedentes:
- Los procedimientos de bypass cardiopulmonar (CPB) conllevan riesgos de formación de coágulos y disfunción plaquetaria.
- La heparina es estándar para la anticoagulación durante la BPC, pero puede tener limitaciones.
- La prostaciclina (IGP2) es conocida por sus efectos vasodilatadores y antiplaquetarios.
Objetivo del estudio:
- Evaluar la eficacia de la prostaciclina (IGP2) con y sin heparina en la prevención de las complicaciones relacionadas con la BPC en perros.
- Evaluar el impacto de la IGP2 y la dosis baja de heparina en el recuento y la función plaquetaria durante la BPC.
- Para determinar si PGI2 puede proporcionar una anticoagulación adecuada y reducir la necesidad de protamina.
Principales métodos:
- Veintiocho perros se sometieron a 2 horas de CPB, divididos en cinco grupos experimentales.
- Los grupos recibieron dosis variables de heparina, prostaciclina (IGP2) y otros fármacos (ibuprofeno, dipiridamolo).
- Se midieron la deposición de coágulos en oxigenadores, el recuento de plaquetas y la agregación plaquetaria.
Principales resultados:
- Se produjo una deposición de coágulos significativa en los oxigenadores en los grupos que recibieron dosis bajas de heparina sola, PGI2 sola o PGI2 con otros medicamentos.
- Los perros que recibieron IGP2 con dosis bajas de heparina mostraron recuentos de plaquetas significativamente más altos (74% del control) en comparación con la heparina estándar (36,8% del control).
- La agregación plaquetaria casi se normalizó en el grupo IGP2 con dosis bajas de heparina, y no se requirió protamina.
Conclusiones:
- La prostaciclina (PGI2) en combinación con dosis bajas de heparina proporciona una eficaz anticoagulación durante el bypass cardiopulmonar canino.
- Esta combinación preserva significativamente el número y la función de las plaquetas, mitigando la trombocitopenia y la disfunción inducidas por CPB.
- El régimen de PGI2 y dosis bajas de heparina se asocia con un sangrado postoperatorio mínimo y elimina la necesidad de protamina.
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