[Amrinone in catecholamine refractory heart failure in septic shock].
The effect of the new positive inotropic and vasodilatator bipyridine-derivate Amrinon on catecholamine-refractive heart insufficiency in septic shock is described. A bolus dose of 1 mg/kg b.w., followed by continuous infusion of Amrinon 10 micrograms/kg b.w./min improved the haemodynamic parameters of all seven patients. The severe tachycardia before therapy was diminished more than 30%, the blood-pressure increased about 25-30%. RAP, PAP and PCWP showed a diminution of 35-45%. The cardiac output increased nearly 100% under therapy. All patients had IPPV with high inspiratory oxygen concentration, with inversed-ratio-ventilation and high positive end-expiratory pressure. Under Amrinon-therapy the initial pulmonary insufficiency diminished. The oliguria/anuria existing before Amrinon-therapy was improved also. Amrinon was given over 24-36 hours, the total dose was between 800 and 1440 mg. Six of the seven patients survived their severe illness; one patient died of pulmonary embolism, confirmed by autopsy, four weeks after Amrinon-therapy.
D000328:Adult; D000368:Aged; D000631:Aminopyridines / Q000627:therapeutic use*; D000676:Amrinone; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D002395:Catecholamines / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004351:Drug Resistance; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D012131:Respiratory Insufficiency / Q000188:drug therapy; D012772:Shock, Septic / Q000150:complications*
D000631:Aminopyridines; D002316:Cardiotonic Agents; D002395:Catecholamines; D000676:Amrinone
Amrinon beim katecholaminrefraktären Herzversagen im septischen Schock.