Nitric oxide in the oxygenator sweep gas reduces platelet activation during experimental perfusion

Mellgren, Karin; Friberg, Lars Göran; Mellgren, Gösta; Hedner, T.; Wennmalm, Åke; Wadenvik, Hans

doi:10.1016/0003-4975(96)00017-3

Cited by 52 publications

(24 citation statements)

References 22 publications

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“…have protective effects on platelet function, activation, consumption and bleeding [22,23]. Our data demonstrate that transmembranous application of gaseous NO attenuates platelet trapping during simulated ECC, confirming previous results [7,24]. Increased formation about methaemoglobin confirmed that NO was diffusing into blood.…”

Section: Discussionsupporting

confidence: 89%

“…In addition, no differences were found between the circuits in terms of reduced MFI of either GPIb or GPIIb-IIIa. Therefore, analysing platelet adhesion molecules on circulating platelets did not reflect the inhibitory effects of gaseous NO in our experiments, confirming other results [24]. We used only small amounts of NO (20 ppm) compared with others (500 and 1000 ppm [25]).…”

Section: Discussionsupporting

confidence: 83%

“…This contrasts with results after the application of 500 ppm NO during ECC in a pig model, in which both platelet trapping and aggregation were attenuated, possibly reflecting a dose-response effect [25]. Mellgren et al [24] investigated the effects of 40 ppm NO on platelets during CPB. In contrast to previous in vitro experiments by the same group, transmembranous application of NO during open heart surgery had only moderate effects on platelet trapping, and no effects on increased b-TG release and impaired platelet aggregation.…”

Section: Figurementioning

confidence: 89%

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Nitric oxide diffusion across membrane lungs protects platelets during simulated extracorporeal circulation

Keh

Gerlach

Kürer

et al. 1999

Eur J Clin Investigation

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 83%

Section: Figurementioning

confidence: 89%

See 1 more Smart Citation

Nitric oxide diffusion across membrane lungs protects platelets during simulated extracorporeal circulation

Keh

Gerlach

Kürer

et al. 1999

Eur J Clin Investigation

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show abstract

“…Again, this diverse group of studies has yielded conflicting results. Some investigators have reported inhibition of platelet function or aggregation [10,14,18-24], while others have found little or no effect [8,11-13,15,25]. …”

Section: Introductionmentioning

confidence: 99%

Effects of inhaled nitric oxide on hemostasis in healthy adults treated with heparin: a randomized, controlled, blinded crossover study

2012

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BackgroundEffects of nitric oxide (NO) on hemostasis have been studied in various investigational settings, but data regarding inhaled NO on bleeding and platelet function are conflicting. It is not known if inhaled NO has an effect when administered with drugs that influence hemostasis. This trial evaluated effects of inhaled NO on hemostasis in the presence of heparin using aspirin as a positive control.Patients/MethodsTwelve healthy adult males were enrolled in a single-center, randomized, single-blind, four-way crossover trial. Subjects received 80 ppm NO or medical air (placebo) inhalation for 30 min with simultaneous injection of placebo or heparin. Aspirin capsules were used as a positive control. Parameters of hemostasis were measured before treatment and at post-treatment intervals.ResultsActivated clotting time (ACT), prothrombin time (PT) and activated partial thromboplastin time (aPTT) increased only in groups that received heparin. Areas under the curve for ACT in heparin groups receiving inhaled NO were judged to be equivalent to those receiving medical air for both 0- to 4-h (ratio: 1.00; 90% CI, 0.90-1.11) and 0- to 24-h time intervals (ratio: 1.01; 90% CI, 0.92-1.12). Changes in bleeding time and platelet aggregation were observed only in aspirin groups. No clinically significant changes in hemoglobin, red blood cell counts or haematocrit were observed in any group.ConclusionsInhaled NO, when administered with heparin, exhibited no significant additive effects on ACT, PT, aPTT, bleeding time or platelet aggregation.

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“…In vitro models have shown that addition of NO to the sweep gas during CPB prevents the usual drop in cyclic guanosine monophosphate for up to 3 h, as well as attenuating the typical fall in platelets [8]. Two small clinical studies of NO during CPB have suggested benefit with a reduction of the duration of postoperative mechanical ventilation alongside reduced serum markers of inflammation and myocardial injury [9,10].…”

mentioning

confidence: 99%

Paediatric cardiopulmonary bypass surgery: the challenges of heterogeneity and identifying a meaningful endpoint for clinical trials

2016

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Nitric oxide in the oxygenator sweep gas reduces platelet activation during experimental perfusion

Cited by 52 publications

References 22 publications

Nitric oxide diffusion across membrane lungs protects platelets during simulated extracorporeal circulation

Nitric oxide diffusion across membrane lungs protects platelets during simulated extracorporeal circulation

Effects of inhaled nitric oxide on hemostasis in healthy adults treated with heparin: a randomized, controlled, blinded crossover study

Paediatric cardiopulmonary bypass surgery: the challenges of heterogeneity and identifying a meaningful endpoint for clinical trials

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