RETRACTED: Cardiorespiratory response of intravenous angiotensin-converting enzyme inhibitor enalaprilat in hypertensive cardiac surgery patients.
Twenty-four patients undergoing elective coronary artery bypass surgery were studied. Either the angiotensin-converting enzyme (ACE) inhibitor enalaprilat, 0.06 mg/kg, (n = 12), or saline solution (= control group; n = 12), was randomly and blindly administered intravenously when the mean arterial blood pressure (MAP) increased to 90 mmHg after induction of anesthesia. Cardiorespiratory parameters were studied before injection, during the subsequent 30 minutes, precardiopulmonary bypass (CPB), post-CPB, and at the end of surgery. MAP was significantly reduced 5 minutes after administration of enalaprilat. The peak reduction of blood pressure was observed after 30 minutes (from 98 +/- 4 to 68 +/- 8 mmHg). Even immediately before CPB (112 +/- 12 minutes after injection of enalaprilat), MAP and systemic vascular resistance were significantly lower than baseline values. Heart rate remained almost unchanged in both groups. Cardiac index increased slightly in the enalaprilat patients (maximum: +0.75 L/min/m2 20 minutes after injection). Filling pressures (central venous pressure, pulmonary capillary wedge pressure) were also significantly reduced by enalaprilat. There were no differences from the control patients with regard to changes in right ventricular hemodynamics (right ventricular ejection fraction, right ventricular end-diastolic volume, right ventricular end-systolic volume), pulmonary gas exchange (PaO2), or intrapulmonary right-to-left shunting (Qs/Qt). VO2 increased only in the enalaprilat patients (from 179 +/- 28 to 230 +/- 30 mL/min) (p < 0.05). Cardiorespiratory parameters did not differ between the two groups post-CPB.(ABSTRACT TRUNCATED AT 250 WORDS)
Boldt
J
J
From the Department of Anesthesiology and Intensive Care Medicine, and the Department of Cardiovascular Surgery, Justus-Liebig-University Giessen, Giessen, Germany.
Schindler
E
E
From the Department of Anesthesiology and Intensive Care Medicine, and the Department of Cardiovascular Surgery, Justus-Liebig-University Giessen, Giessen, Germany.
Wollbrück
M
M
From the Department of Anesthesiology and Intensive Care Medicine, and the Department of Cardiovascular Surgery, Justus-Liebig-University Giessen, Giessen, Germany.
Görlach
G
G
From the Department of Anesthesiology and Intensive Care Medicine, and the Department of Cardiovascular Surgery, Justus-Liebig-University Giessen, Giessen, Germany.
Hempelmann
G
G
From the Department of Anesthesiology and Intensive Care Medicine, and the Department of Cardiovascular Surgery, Justus-Liebig-University Giessen, Giessen, Germany.
D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D002306:Cardiac Volume / Q000187:drug effects; D002315:Cardiopulmonary Bypass; D002496:Central Venous Pressure / Q000187:drug effects; D001026:Coronary Artery Bypass; D017558:Elective Surgical Procedures; D015773:Enalaprilat / Q000008:administration & dosage / Q000627:therapeutic use*; D006321:Heart / Q000187:drug effects*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007275:Injections, Intravenous; D008875:Middle Aged; D010101:Oxygen Consumption / Q000187:drug effects; D010919:Placebos; D011659:Pulmonary Gas Exchange / Q000187:drug effects; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D012119:Respiration / Q000187:drug effects*; D016037:Single-Blind Method; D013318:Stroke Volume / Q000187:drug effects; D014655:Vascular Resistance / Q000187:drug effects; D016278:Ventricular Function, Right / Q000187:drug effects
D010919:Placebos; D015773:Enalaprilat