Prostacyclin (PGl2), the most potent and short-lived antiplatelet agent known today, has been used successfully as an antithrombotic in hemodialysis (HD). However, its vasodilatory effect has been the source of blood pressure instability in acetate HD and has restricted its use to bicarbonate HD. The authors took advantage of the better cardiovascular stability obtained with hemofiltaration (HF) to compare the effects of PGI2 versus heparin either with acetate or bicarbonate HF in 4 patients. Efficacy of PGI2 in preventing thrombosis of the extracorporeal circuit was demonstrated in all cases with a dose of 4 ng/kg/min. HF performances remained unaffected whatever antithrombotic agent was used. Platelet activation as shown by BTG and PF4 release was inhibited by the PGI2 infusion. Platelet proteins release was greater with acetate HF, suggesting that acetate may have a specific role in platelet activation. Although the use of PGI2 was straightforward, it is worth noting that PGI2 partially suppressed the cardiostability usually associated with acetate HF. We conclude that the efficacy of PGI2 was well maintained in spite of conditions of high platelet shear stress conditions, but also that PGI2 potentiated the vasodilatory effect of acetate and suppressed partially the cardiovascular benefits of HF.

This content is only available via PDF.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.