Postoperative management of patients with Hemopump support after coronary artery bypass grafting.
BACKGROUND
In this study, we describe postoperative monitoring, pharmacologic therapy, and hemodynamic responses in patients receiving Hemopump support after postcardiotomy heart failure.


METHODS
The Hemopump was used in 24 patients with severe left ventricular dysfunction after coronary artery bypass grafting.


RESULTS
Fourteen patients (58%) were weaned from the Hemopump. Low to moderate doses of a combination of catecholamines, phosphodiesterase inhibitors, vasodilators, and vasoconstrictors were required to optimize Hemopump function and left ventricular unloading. Mean arterial blood pressure, mixed venous oxygen saturation, and urinary output were the most important therapy guidelines.


CONCLUSIONS
Together with our clinical protocol, the Hemopump effectively unloaded the failing ventricle while maintaining vital-organ perfusion. Doses of vasoactive drugs could be kept low. This approach to treatment provides good conditions for recovery of the stunned myocardium.
Peterzén
B
B
Linköping Heart Center, University of Linköping, Sweden.
Lönn
U
U
Babić
A
A
Granfeldt
H
H
Casimir-Ahn
H
H
Rutberg
H
H
D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002303:Cardiac Output, Low / Q000188:drug therapy / Q000628:therapy; D002316:Cardiotonic Agents / Q000627:therapeutic use; D001026:Coronary Artery Bypass / Q000009:adverse effects; D004280:Dobutamine / Q000627:therapeutic use; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D017682:Myocardial Stunning / Q000188:drug therapy / Q000628:therapy; D009638:Norepinephrine / Q000627:therapeutic use; D010100:Oxygen / Q000097:blood; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D011182:Postoperative Care; D014556:Urine; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy / Q000628:therapy; D016277:Ventricular Function, Left / Q000187:drug effects
D000316:Adrenergic alpha-Agonists; D002316:Cardiotonic Agents; D010726:Phosphodiesterase Inhibitors; D014662:Vasoconstrictor Agents; D014665:Vasodilator Agents; D004280:Dobutamine; D010100:Oxygen; D009638:Norepinephrine; D004837:Epinephrine