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.
Clinic for Anaesthesiology and Surgical Intensive Care, Christian-Albrechts-University, Kiel, Germany.
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A
Petry
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P
Dütschke
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D
Regensburger
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