[Hemodynamic correction of patients with acute myocardial infarct in hemodynamic subgroup III by plasma-exchange expansion with low-molecular dextran].
To 20 patients with acute myocardial infarction from the III hemodynamic group catheterized with a microcatheter or a balloon thermodilution catheter 332 (from 100 up to 500) ml of a 10% solution dextran 40 were infused intravenously with mean velocity of 33 ml/min. The cardiac index was measured by the dye or thermodilution methods. The left ventricular filling pressure (LVFP) increased with 47% (from 1.7 +/- 0.4 to 2.5 +/- 0.5 kPa), the cardiac index--15.8% (from 2.02 +/- 0.8 to to 2.34 +/- 0.37 l/min/m2), systolic and diastolic arterial pressure with 7.7%, stroke index--with 10.2% stroke working index--with 10.7%, total pulmonary resistance--with 37.9% (il all, p less than 0.001), cardiac rate--with 4.7% (p less than 0.05) but the systemic arterial resistance did not change (p greater than 0.10). The increase of the cardiac index for an increase of LVFP with I KPa was almost equal in the patients with different initial LVFP but was due mainly to the increase of the stroke index by LVFP below 1.3 kPa and to an increase of the heart rate by LVFP above 2.0 kPa. The cardiac index increased above 2.2 l/min/m2 in 45% of the patients (87% by LVFP below 1.3 kPa, 56% by LVFP 1.4-1.9 kPa and 0% by LVFP above 2 kPa). The cardiac rate remained increased up to the 4th hour after the infusion. The arterial pressure fell below its initial value after 30 min and remained low up to the 12 h. The LVFP decreased progressively according to the dependence: LVFP = -5.06 + 2.09 1g T.(ABSTRACT TRUNCATED AT 250 WORDS)
Daskalov
T
T
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D003911:Dextrans / Q000008:administration & dosage*; D005260:Female; D006352:Heart Ventricles / Q000187:drug effects / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D010951:Plasma Exchange / Q000379:methods*; D013997:Time Factors
D003911:Dextrans
Korektsiia na khemodinamikata na bolni ot ostŭr miokarden infarkt ot III khemodinamichna podgrupa chrez plazmena obemna ekspanziia s nizkomolekuliaren dekstran.