Treatment of acute left heart failure using dobutamine and intraaortic counterpulsation. Animal experiments and first clinical experiences.
Ten anesthetized mongrel dogs had a left anterolateral thoracotomy; the left anterior descending coronary artery was then ligated. After 60 min five animals each were treated either with dobutamine (4 microgram/min/kg; for 10 min), or with dobutamine and intraaortic counterpulsation. Combined treatment of cardiogenic shock proved superior. Those five dogs had significantly lower heart rates and dp/dt/p-values. Due to IABP the non-ischemic parts of the left ventricle were better perfused; there was no difference in treatment with regard to ischemic parts. The combined treatment was successfully inaugurated in two patients with cardiogenic shock.
D000328:Adult; D000818:Animals; D001243:Assisted Circulation; D002395:Catecholamines / Q000008:administration & dosage*; D001026:Coronary Artery Bypass; D003326:Coronary Circulation / Q000187:drug effects; D003331:Coronary Vessels / Q000601:surgery; D004280:Dobutamine / Q000008:administration & dosage*; D004285:Dogs; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008875:Middle Aged; D012770:Shock, Cardiogenic / Q000503:physiopathology / Q000628:therapy*
D002395:Catecholamines; D004280:Dobutamine