Enoximone vs nicardipine during the early postoperative course of patients undergoing cardiac surgery. A prospective study of two therapeutic strategies.
The hemodynamic effects of enoximone and nicardipine were compared during the early postcardiac surgery period in 40 patients with systemic hypertension and moderate cardiac dysfunction. Patients were prospectively randomized into two groups. Mean right atrial pressure was maintained above 7 mm Hg. The drug infusion rate was adjusted to maintain mean systemic artery pressure (SAP) within the 65 to 80 mm Hg range. Complete hemodynamic evaluations were performed before any drug infusion and during the following 24 h with special attention to O2-related variables. Oxygen consumption, cardiac index, and stroke index improved significantly and similarly in the two groups. The SAP and systemic vascular resistance decreased more rapidly in the enoximone group but whole body lactate level increased after the second hour of infusion. Furthermore, this was paralleled by an arteriovenous O2 contents difference deficit. In our study, nicardipine was found superior over enoximone in terms of recovery from intraoperative tissue hypoxia. Furthermore, enoximone's inotropic effects were not found to be clinically relevant.
CERIC Intensive Care Unit, Clinique Ambroise Paré, Neuilly, France.
P
P
Squara
D
D
Denjean
P
P
Godard
F
F
Brunet
A
A
Brusset
C
C
Dubois
D006348:Cardiac Surgical Procedures; D004311:Double-Blind Method; D017335:Enoximone / Q000627:therapeutic use*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007773:Lactates / Q000097:blood; D008297:Male; D009529:Nicardipine / Q000627:therapeutic use*; D010101:Oxygen Consumption; D011182:Postoperative Care; D011446:Prospective Studies
D007773:Lactates; D017335:Enoximone; D009529:Nicardipine