[Enoximone in postoperative "low-output syndrome"--comparison with dobutamine].
Low output syndrome sometimes complicates early postoperative states following cardiac surgery. A comparative study of hemodynamic responses to enoximone and dobutamine was carried out in two groups of 20 patients each, during a 22-24 hour postoperative observation period. Enoximone, 1 mg/kg i.v. total dose, was given in the first 20 minutes. The infusion was then reduced to 2-10 micrograms.kg-1.min-1 for the next 22-24 hours. Dobutamine was administered in a dose of 4-7 micrograms.kg-1.min-1 over the same period. After 15 minutes of therapy with enoximone cardiac index increased by 42% (initial value 2.31 +/- 0.34 l/min/m2), after 30 minutes by 50%, after 120 minutes by 65% and after 24 hours by 91% from the initial value. At the same time the pulmonary capillary wedge pressure decreased from the initial value of 15.21 +/- 1.65 mmHg by 20%, 25%, 26% and by 43% (22 hours). After dobutamine cardiac index increased from 2.23 +/- 0.6 l/min/m2 by 30% (15 minutes), 47% (30 minutes), 57% (2 hours) and by 85% (22 hours). The pulmonary capillary wedge pressure decreased from 15.70 +/- 3.14 mmHg by 13% (15 minutes), 17% (30 minutes), 22% (2 hours) and by 43% (22 hours). The enoximone group showed a diminution of systolic arterial pressure of 14% in the first 120 minutes, with a return to initial values after 22 hours. Dobutamine produced an increase in systolic arterial pressure of 23% after 2 hours, maintaining increased values of approximately 20% during the observation period. Heart rate increase slightly in both groups in a similar way.(ABSTRACT TRUNCATED AT 250 WORDS)
Orellano
L
L
Kerckhoff-Klinik, Bad Nauheim.
Darwisch
M
M
Dieterich
H A
HA
Köllner
V
V
D000368:Aged; D002303:Cardiac Output, Low / Q000188:drug therapy* / Q000503:physiopathology; D002316:Cardiotonic Agents; D004280:Dobutamine / Q000627:therapeutic use*; D017335:Enoximone; D005260:Female; D006439:Hemodynamics / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects / Q000502:physiology; D010726:Phosphodiesterase Inhibitors; D011183:Postoperative Complications / Q000188:drug therapy* / Q000503:physiopathology; D011669:Pulmonary Wedge Pressure / Q000187:drug effects / Q000502:physiology; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology
D002316:Cardiotonic Agents; D007093:Imidazoles; D010726:Phosphodiesterase Inhibitors; D004280:Dobutamine; D017335:Enoximone
Enoximon beim postoperativen "Low-output-Syndrom"--Vergleich mit Dobutamin.