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Abstract
A group of 48 critically injured patients were entered into a prospective, double-blind,
placebocontrolled trial to evaluate the efficacy of early infusion of PGE1 for reducing the incidence of severe respiratory failure and mortality. Secondary
assessments examined the effects of the PGE1 infusion on plasma mediated suppression of PMN superoxide production and loss of
PMN granule enzyme content. The incidence of severe respiratory failure was lower
in the PGE1 group — 13% versus 32%, but this did not reach significance. The overall morality
was equivalent between the two groups — 26% (PGE1) versus 28% (placebo). The suppressive activity of the patient plasma was assayed
by measurement of normal PMN superoxide production relative to normal control plasma
(ratio P:C). The baseline ratio P:C was 62 ± 5% in the PGE1 group versus 60 ± 5% in the placebo group. The day 1 plasma samples showed significant
reversal of plasma suppressive activity in the PGE1 group — ratio P:C 88 ± 5% versus 67 ± 5% in the placebo group (P < 0.02). In patients
who received the full 7 days of infusion, the plasma suppressive activity remained
significantly diminished in the PGE1 group — ratio P:C 77 ± 4% versus 61 ± 5% (P < 0.04). The baseline lysozyme content
of patient PMN's relative to that of normal control PMNs (ratio P:C) was 119 ± 14%
in the PGE1 group. A significant loss of lysozyme content was observed in the PGE1 group on day 1 of the infusion — ratio P:C 79 ± 8% (P < 0.03), and was associated
with a reduction in the plasma suppressive activity. Although no significant clinical
benefit could be attributed to the PGE1 infusion, these studies indicate that infusion of PGE1 was associated with attenuated production of post traumatic plasma suppressive factors
of PMN activation.
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Article info
Publication history
Accepted:
July 3,
1991
Received:
May 6,
1991
Identification
Copyright
© 1991 Published by Elsevier Inc.
