Pharmacological inhibition of plasma coagulation and platelet activation during experimental long-term perfusion

Objective --During extracorporeal circulation, initial contact between blood and the artificial surface of the circuit induces an overall activation of the hemostatic system. The objective of this study was to investigate the combined effect of epoprostenol (PGI 2 ), nitric oxide (NO) and nafamostat mesilate (FUT-175, a serine protease inhibitor), on plasma coagulation and platelet activation during experimental long-term perfusion. Design --Two identical extracorporeal life support (ECLS) circuits were primed with fresh, heparinized human blood, and circulated for 24 r h. FUT was given with a bolus dose of 85 r mg/l blood at the initiation of the experiment and thereafter as a continuous infusion of 14 r mg/l/h. PGI 2 , at a rate of 2.4 r 7 g/l/h, was also administered to the experimental circuit, and 120 r ppm NO gas was added to the oxygenator sweep gas. The other circuit was used as a control. Results --Higher platelet count and platelet membrane expression of GPIb were found in...