title: Nitroprusside and epinephrine for treatment of low output in children after open-heart surgery.
abstract: We evaluated the acute hemodynamic effects of treatment of the low output state with sodium nitroprusside and epinephrine in 13 children after intracardiac operation. The 13 patients were selected from a consecutive series of 106 children undergoing cardiopulmonary bypass. They had a cardiac index less than 2.0 L/min/m2, even after an increase in left ventricular filling pressure and during infusion of nitroprusside. Although the nitroprusside brought about a significant increase in cardiac output and decrease in systemic vascular resistance, the cardiac index remained critically low (less than 2 L/min/m2). Epinephrine resulted in a further significant increase in the cardiac index, without a significant change in systemic resistance. This study suggests that in selected patients the simultaneous use of both a vasodilator drug (sodium nitroprusside) and a positive inotropic agent (epinephrine) is advantageous in the short-term treatment of the low cardiac output state after intracardiac operation.
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004341:Drug Evaluation; D004837:Epinephrine / Q000008:administration & dosage / Q000627:therapeutic use*; D005292:Ferricyanides / Q000627:therapeutic use*; D006330:Heart Defects, Congenital / Q000601:surgery; D006349:Heart Valve Diseases / Q000601:surgery; D006801:Humans; D007223:Infant; D007263:Infusions, Parenteral; D009200:Myocardial Contraction / Q000187:drug effects*; D009599:Nitroprusside / Q000008:administration & dosage / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy*; D013997:Time Factors; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D005292:Ferricyanides; D009599:Nitroprusside; D004837:Epinephrine