[Arrhythmia in patients with low cardiac output after valvular surgery. Randomized, double-blind comparative study of dobutamine versus enoximone].
Forty patients with low cardiac output (cardiac index less than 2.2 l/mn/m2 and pulmonary wedge pressure greater than 15 mmHg) after valvular surgery were randomised into two groups. Patients in Group 1 were given 5 to 10 micrograms/Kg/mn of Dobutamine (D) and those In Group 2 a bolus of Enoximone (E) 1 mg/kg followed by an intravenous infusion of 5 to 10 micrograms/Kg/mn. Holter ECG monitoring over 42.65 +/- 6.02 hrs (24-48 hours) was obtained and interpreted blindly in 37/40 patients (19 Group D and 18 Group E). The results were analysed by the t and X2 tests. A p value of less than .05 was considered statistically significant. The two groups were comparable. No deaths occurred during the protocol period. The total duration of inotropic therapy (86 +/- 49 hours) and the period spent in the intensive care unit (155 +/- 129 hours) were longer in Group D than in Group E (60 +/- 23 hrs and 92 +/- 37 hrs, respectively; p less than .05). Antiarrhythmic therapy was used more often in Group D (4 patients) than in group E (1 patient) (p = 0.09).(ABSTRACT TRUNCATED AT 250 WORDS)
Atallah
G
G
Centre de lecture Holter-ECG, Lyon.
George
M
M
Lehot
J J
JJ
Bastien
O
O
Bejuit
R
R
Durand
P G
PG
Estanove
S
S
D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D002303:Cardiac Output, Low / Q000188:drug therapy* / Q000209:etiology; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D004280:Dobutamine / Q000627:therapeutic use*; D004311:Double-Blind Method; D004341:Drug Evaluation; D015716:Electrocardiography, Ambulatory; D017335:Enoximone; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D011183:Postoperative Complications; D011446:Prospective Studies
D002316:Cardiotonic Agents; D007093:Imidazoles; D004280:Dobutamine; D017335:Enoximone
Arythmies chez les patients en bas débit cardiaque après chirurgie valvulaire. Etude randomisée, aveugle et comparative dobutamine versus énoximone.