Effects of cardiovascular drugs on oxygen consumption/oxygen delivery relationship in patients with congestive heart failure.
The oxygen consumption (VO2)/oxygen delivery (DO2) relationship was analyzed in ten patients with severe congestive heart failure (CHF) and normal blood lactate levels. First dobutamine and then enoximone, after a washout period, were administered to each patient to increase cardiac output by at least 15 percent. Similar increases in DO2 were obtained with both drugs: from 285 +/- 46 to 393 +/- 87 ml/min/m2 for dobutamine, and from 285 +/- 54 to 392 +/- 99 ml/min/m2 for enoximone. However, while VO2 did not change (132 +/- 24 vs 132 +/- 21 ml/min/m2) (VO2/DO2 independency) with a dobutamine infusion (mean dose of 10 +/- 2 micrograms/kg/min), a significant increase in VO2 from 134 +/- 22 to 157 +/- 21 ml/min/m2 was observed with a bolus infusion of enoximone (mean dose of 1.7 +/- 0.5 mg/kg). These results, observed in patients with CHF without patent oxygen debt, suggest that an artefactual VO2/DO2 dependency might be induced by the cardiovascular drug used to elevate DO2, probably because of a drug-induced oxygen demand increase.
Teboul
J L
JL
Service de Réanimation Médicale, Université Paris-Sud, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
Annane
D
D
Thuillez
C
C
Depret
J
J
Bellissant
E
E
Richard
C
C
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000494:pharmacology*; D002407:Catheterization, Swan-Ganz; D002908:Chronic Disease; D004280:Dobutamine / Q000008:administration & dosage / Q000494:pharmacology; D017335:Enoximone; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000187:drug effects* / Q000502:physiology; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology; D011654:Pulmonary Edema / Q000188:drug therapy / Q000503:physiopathology
D002317:Cardiovascular Agents; D007093:Imidazoles; D010726:Phosphodiesterase Inhibitors; D004280:Dobutamine; D017335:Enoximone