Less peri- and postoperative inotropic support in open-heart patients with vasomotor waves during cardiopulmonary bypass?
Although vasomotor waves (VMW) (Mayer waves) were recognized more than one century ago their physiological role is still under discussion. During cardiopulmonary bypass (CPB) the appearance of VMW is random. The clinical significance of the phenomenon was studied by comparing open-heart patients with (n = 33) or without (n = 33) VMW of arterial pressure during CPB. The patients with VMW had higher perfusion pressure (p less than 0.05) and vascular resistance (p less than 0.01) during bypass and higher mean arterial pressure before and after CPB. During CPB the need for vasoconstrictors was of lesser magnitude (p less than 0.01) but the need for vasodilators was of greater magnitude (p less than 0.001) in patients with VMW and they also less frequently needed inotropic support at weaning from CPB (p less than 0.05) or after CPB (p less than 0.01). The use of inotropics was also shorter (p less than 0.01) during intensive care in the patients with VMW. Based on the present results the open-heart patients who had VMW during CPB appeared to have higher arterial blood pressure and to need less pharmacological cardiovascular support during the intraoperative and the immediate postoperative period.
Vainionpää
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Department of Anaesthesiology, University Hospital of Oulu, Finland.
D001794:Blood Pressure; D002315:Cardiopulmonary Bypass; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D002496:Central Venous Pressure; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000502:physiology; D011669:Pulmonary Wedge Pressure; D014655:Vascular Resistance; D014666:Vasomotor System / Q000502:physiology*
D002316:Cardiotonic Agents