Beneficial hemodynamic effects of intravenous terbutaline in patients with severe heart failure.
The hemodynamic effects of terbutaline infusion at rates of 0.15, 0.3, and 0.45 micrograms/kg/min were studied and compared in eight patients with severe heart failure. Terbutaline infusion at 0.15 micrograms/kg/min infusion produced insignificant effects at 30 minutes. At 0.3 micrograms/kg/min infusion highly significant beneficial hemodynamic effects were observed: at 60 minutes cardiac index increased from 1.79 +/- 0.38 to 3.60 +/- 0.96 (mean +/- SD) L/min/m2 (p less than 0.0001) and stroke volume index increased from 20.1 +/- 6.2 to 36.7 +/- 13.1 ml/beat/m2 (p less than 0.0001); mean pulmonary artery wedge pressure fell from 27.5 +/0- 5.5 to 18.5 +/- 5.7 mm Hg (p less than 0.0001); systemic vascular resistance fell from 2624 +/- 586 to 1455 +/- 500 dynes . sec . cm-5/m2 (p less than 0.0001); and pulmonary vascular resistance fell from 248 +/- 84 to 150 +/- 70 dynes . sec . cm-5/m2 (p less than 0.0005). Mean arterial pressure and O2 uptake did not change significantly; however, mean heart rate increased from 93.4 +/- 22 to 103.1 +/- 26 bpm (p less than 0.005) and plasma potassium fell from 3.86 +/- 0.14 to 3.12 +/ 0.23 mEq/L (p less than 0.05). The 0.45 micrograms/kg/min infusion at 30 minutes produced no greater hemodynamic changes than that from 0.3 micrograms/kg/min. Our study suggests that intravenous terbutaline produces beneficial effects and may be useful in the acute management of severe heart failure.
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002302:Cardiac Output; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D013318:Stroke Volume; D013726:Terbutaline / Q000008:administration & dosage*; D014655:Vascular Resistance
D013726:Terbutaline; D010100:Oxygen