[Enoximone in the postoperative phase of heart surgery].
Ten patients with low cardiac output syndrome (LCOS, cardiac index [CI] = 1.8 +/- 0.24 L.min-1.m-2, pulmonary artery occlusion pressure [PAOP] = 19 +/- 4 mmHg, systolic arterial pressure [APsys] = 76 +/- 5 mmHg) were treated with catecholamines and nitroglycerin. This therapy achieved stable hemodynamic conditions (CI 2.5 +/- 0.2 L.min-1.m-2, PAOP 14 +/- 5 mmHg, APsys = 110 +/- 17 mmHg). Addition of enoximone (bolus dose 1.0 mg.kg-1 followed by continuous infusion of 7 micrograms.kg-1.min-1) induced an increase of CI to 3.6 +/- 1.3 L.min-1.m-2 (p < 0.05) and of left ventricular stroke work index (LVSWI) from 21.8 +/- 3.6 g.m.m-2 to 29.3 +/- 10.1 g.m.m-2 (p < 0.05). Systemic vascular resistance decreased from 1300 +/- 415 dyn.s.cm-5 to 972 +/- 390 dyn.s.cm-5 (p < 0.01). No alterations of heart rate, mean arterial or pulmonary arterial pressure and PAOP were observed. Likewise, enoximone had no effect on gas exchange. Oxygen consumption index (VO2I) was elevated from 83 +/- 22 mL.min-1.m-2 to 126 +/- 31 mL.min-1.m-2 (p < 0.01) and oxygen delivery index (DO2I) increased from 348 +/- 112 mL.min-1.m-2 to 498 +/- 206 mL.min-1.m-2 (p < 0.05). In contrast, oxygen extraction ration remained unchanged (29 +/- 10% n.s.). Oxygen consumption and delivery were significantly lower during treatment of LCOS with catecholamines and nitroglycerin when compared with a matched group of patients without postoperative cardiac failure.(ABSTRACT TRUNCATED AT 250 WORDS)
Hachenberg
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Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Westfälische Wilhelms-Universität Münster.
D000368:Aged; D002303:Cardiac Output, Low / Q000188:drug therapy* / Q000503:physiopathology; D002395:Catecholamines / Q000008:administration & dosage / Q000009:adverse effects; D001026:Coronary Artery Bypass; D004359:Drug Therapy, Combination; D004562:Electrocardiography / Q000187:drug effects; D017335:Enoximone / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage / Q000009:adverse effects; D010100:Oxygen / Q000097:blood; D011183:Postoperative Complications / Q000188:drug therapy* / Q000503:physiopathology; D011659:Pulmonary Gas Exchange / Q000187:drug effects / Q000502:physiology; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology; D014655:Vascular Resistance / Q000187:drug effects / Q000502:physiology
D002395:Catecholamines; D017335:Enoximone; D005996:Nitroglycerin; D010100:Oxygen
Enoximon in der postoperativen Phase der Herzchirurgie.