[Ketanserin versus sodium nitroprusside in the treatment of hypertension following coronary surgery. Effect on intrapulmonary right and left shunt and arterial oxygenation].
Twenty patients requiring management of postoperative arterial hypertension following coronary artery bypass grafting (CABG) were randomly treated with either ketanserin (n = 10) or sodium nitroprusside (SNP) (n = 10). After surgery all patients were mechanically ventilated in the intensive care unit (F1O2:0.5; PEEP: +5 cm H2O). During the therapy with either drug F1O2 was adjusted to achieve normal blood oxygen tensions (F1O2 always greater than 0.3). Samples of arterial and mixed-venous blood were obtained simultaneously before administration of either drug and at each time point. Data acquisition followed over 12 h. Both drugs led to a significant decrease in arterial blood pressure, although 2 patients had to be withdrawn from the ketanserin group because there was no adequate decrease in systolic arterial pressure. A significant increase in heart rate was noted only in patients receiving SNP. In the SNP-treated patients F1O2 had to be increased because of a marked decrease in paO2, resulting in a significant increase in alveolar-arterial oxygen difference (A-aDO2). In 3 patients SNP had to be stopped because of an increase in intrapulmonary shunt (Qsp/Qt) more than 30%. No significant changes in Qsp/Qt, A-aDO2, or paO2 were seen in the ketanserin-treated patients.
Möllhoff
T
T
Department of Anesthesiologie, Katholieke Universiteit Leuven, Belgien.
Mulier
J P
JP
Müller
E
E
Van Aken
H
H
Lauwers
P
P
D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery*; D005292:Ferricyanides / Q000627:therapeutic use*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007650:Ketanserin / Q000627:therapeutic use*; D009599:Nitroprusside / Q000627:therapeutic use*; D010100:Oxygen / Q000097:blood*; D011183:Postoperative Complications / Q000188:drug therapy*; D011652:Pulmonary Circulation / Q000187:drug effects*; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D016032:Randomized Controlled Trials as Topic; D014661:Vasoconstriction / Q000187:drug effects
D005292:Ferricyanides; D009599:Nitroprusside; D007650:Ketanserin; D010100:Oxygen
Ketanserin versus Natriumnitroprussid in der Behandlung der Hypertonie nach koronarchirurgischen Eingriffen. Einfluss auf den intrapulmonalen Rechts- und Links-Shunt und die arterielle Oxygenation.