These findings may be explained by previous observations that PGEt overcomes the platelet aggregation and neutrophil margination stimulated by thromboxane. These events were thought to occur in the pulmonary circulation, but the present study indicates that these actions also may take place in the systemic circulation, that is, the infused PGE, not taken up on transit through the lungs may similarly affect the systemic and coronary circulations to improve overall blood flow and tissue perfusion. buy flovent inhaler
In summary, PGEi has ancillary therapeutic effects but is not the primary agent for shock and critical illness. Nevertheless, after fluid therapy has been adequately and aggressively administered, PGE! may be effective in improving tissue perfusion as indicated by increased Do2 and Vo2. Only transient and insignificant effects may occur when PGE, is given to the hypovolemic patient because the hypovolemic patient continues to produce unevenly distributed flow. Similarly, the PGE! effects are limited in the late postoperative course when circulatory alterations may be advanced and irreversible. Increased plasma volume and blood flow increases Do2 and Vo2 presumably by opening up previously vasoconstricted microcircula-tory pathways. The present study suggests that PGE! whose action is to disaggregate platelets and leukocytes,* also improves tissue perfusion and oxygenation especially in the early postoperative period in volume-loaded patients. Evidence for this effect is shown by improved Do2 and Vo2.