Previous studies of PGE, in postoperative ARDS showed pulmonary vasodilation with reduced pulmonary artery pressure and PaOP followed several hours later by improved blood gas values and reduced pulmonary right-to-left shunt; this was interpreted as evidence that the initial primary PGE, effect in early postoperative ARDS was pulmonary vasodilation evidenced by reduced pulmonary vascular resistance, pulmonary arterial pressure, and PaOP. These findings were associated with improved distribution of flow and improved lung function. An unexpected finding was increased CO, Do2, and Vo2, suggesting that PGE, also had an appreciable effect on the systemic circulation. Holcroft et al2 demonstrated reduced mortality in patients given PGE,. However, Bone et al in a multi-institutional study found no improvement in mortality or morbidity. In ARDS patients given PGI2, Bihari and Tinker showed increased Vo2 with increasing values of Do2 in survivors but not in those who died. proventil inhaler
The present study was undertaken to test the hypothesis that PGE, may improve systemic tissue perfusion after adequate fluid therapy in the critically ill surgical patients who did not yet have ARDS. First, in an open-label study of 18 postoperative patients, the effects and limitations of PGE, were observed.