Combined administration of nitric oxide gas and prostacyclin into the oxygenator protects platelet activation and function during cardiopulmonary bypass in humans
Bibliographic record
Abstract
Objectives: We studied the effects of combined nitric oxide (NO) and prostacyclin (PGI2) given directly into the oxygenator on platelet function and platelet-leukocyte interactions in patients undergoing CABG. Material and Methods: Blood samples from 41 patients randomized to control, NO (20 ppm), PGI2 (20 ng/kg/min) or combined treatment groups were collected during CPB. Platelets and leukocytes were counted. Platelet membrane glycoprotein (GP) Ib and GPIIb/IIIa expression, P-selectin, platelet-derived microparticles (MP), Mac-1 expression on leukocytes, and platelet-leukocyte aggregate (PLA) were quantified by flow cytometry. Collagen and thrombin receptor-activating peptide (TRAP)-induced platelet aggregation was analyzed by impedance method. Concentrations of cAMP and cGMP in blood cells and plasma were measured by enzyme immunoassay. Results: NO and PGI2 attenuated CPB-induced thrombocytopenia (control: 170±12 vs. NO+ PGI2: 220±24, p<.05), reduced GP expression (control: 890±39 vs. NO+ PGI2: 220±26, p<.05) and P-selectin levels (control:18±1.2 vs. NO+ PGI2: 14±0.8, p<.05), MP formation (control: 11±0.4 vs. NO+ PGI2: 7.6±1 p<.05), Mac-1 upregulation (control:820±100 vs. NO+ PGI2:660 142±, p<.05), and suppression of collagen-induced aggregation. Combined treatment was more effective than the single compound in the prevention of thrombocytopenia, MP formation, P-selectin expression and preservation of TRAP-induced aggregation. Postoperative chest tube loss was lower in the combined treatment goup (control 730±80 vs. NO+ PGI2: 450±60, p<.05). Conclusions: Combined NO and PGI2 reduce CPB induced thrombocytopenia, platelet activation, leukocyte activation, PLA formation and suppression of platelet aggregatory response. In addition, the reduced postoperative bleeding observed with NO and combined treatment suggest that this a novel therapeutic option for patients receiving cardiac surgery with the use of CPB.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".