Hemodynamic effects of prostaglandin E1 during cardiopulmonary bypass in infants and children

Effects of prostaglandin E₁ (PGE₁) and phenoxybenzamine (POB) on the hemodynamics during cardiopulmonary bypass (CPB) were studied in 30 infants and children. Patients were grouped into three; PGE₁ was given to ten patients, POB to another ten, and the other ten patients served as the control. Vasodilative drugs were witheld. PGE₁ was infused at 0.01 to 0.02 μg/kg/min during CPB, and POB at 1.0 mg/kg within the initial 10 minutes of bypass. There was a significant drop in arterial and venous pressure at the time of initiation of bypass in both the PGE₁ and POB groups. In the PGE₁ group in particular, such a stable hemodynamic condition of over 60 mm Hg in mean arterial pressure, 7.5 to 12.5 cmH₂O in central venous pressure, 1300 to 1700 dynes·sec·cm⁻⁵ in systemic vascular resistance was maintained throughout CPB, as compared with the other two groups. PGE₁ contributed to an adequate diuresis and the preservation of platelets. Our findings indicate that PGE₁ has potential clinical advantages for application during CPB.