Effects of enoximone on right-ventricular function in patients with impaired myocardial performance.
The effects of an enoximone monotherapy on left-ventricular and especially on right-ventricular haemodynamics were investigated in fourteen patients with impaired left-ventricular function secondary to coronary artery disease. Anaesthesia was induced and maintained with fentanyl and flunitrazepam. After reaching steady state, a bolus of 0.5 mg/kg enoximone was administered, followed by an infusion of 0.5 microgram/kg/min. Besides the common haemodynamic parameters particulary the right-ventricular ejection fraction (RVEF) was measured using a special thermodilution technique. The predefined time points were: before administration of enoximone (baseline) and 5 min, 10 min, 15 min, 20 min, and 30 min after bolus injection of enoximone. Compared to the baseline the maximum effects of enoximone were a 28% increase of cardiac index accompanied by a 39% decline of systemic vascular resistance and an unchanged left-ventricular stroke-work index. While central venous pressure and mean pulmonary artery pressure remained unchanged. RVEF (+20%) and right-ventricular stroke-work index (+30%) were significantly augmented, augmented, indicating improved right-ventricular performance. No adverse effects of the enoximone administration were observed perioperatively. We conclude that an enoximone monotherapy is beneficial for patients with impaired myocardial function undergoing cardiac surgery.
Petry
A
A
Clinic for Anaesthesiology and Surgical Intensive Care, Christian-Albrechts-University, Kiel, Germany.
Dütschke
P
P
Regensburger
D
D
D000328:Adult; D000368:Aged; D002316:Cardiotonic Agents / Q000494:pharmacology*; D003327:Coronary Disease / Q000503:physiopathology* / Q000601:surgery; D017335:Enoximone / Q000494:pharmacology*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008875:Middle Aged; D009204:Myocardial Revascularization; D010726:Phosphodiesterase Inhibitors / Q000494:pharmacology*; D013318:Stroke Volume / Q000187:drug effects; D013815:Thermodilution; D018497:Ventricular Dysfunction, Right / Q000503:physiopathology*; D016278:Ventricular Function, Right / Q000187:drug effects*
D002316:Cardiotonic Agents; D010726:Phosphodiesterase Inhibitors; D017335:Enoximone