Attenuation of postoperative noradrenaline need by nitric oxide inhibition using L-NMMA.
In the present report we describe that NG-monomethyl-L-arginine acetate, a non-specific nitric oxide synthesis inhibitor, administered at 1 mg kg(-1) h(-1) to a patient with critical hypotension following mitral valve surgery combined with passive containment surgery, increased the urinary output and arterial blood pressure while the need for noradrenaline was rapidly attenuated. Again increasing the noradrenaline infusion in the presence of NG-monomethyl-L-arginine acetate caused a dramatic increase of the blood pressure.
Franco-Cereceda
Anders
A
Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden. andfra@mbox.ki.se
Holm
Peter
P
Bredin
Fredrik
F
Adding
Christoffer
C
D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D000075202:Contraindications; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery*; D009569:Nitric Oxide / Q000037:antagonists & inhibitors*; D009638:Norepinephrine; D011184:Postoperative Period; D014662:Vasoconstrictor Agents; D019323:omega-N-Methylarginine / Q000627:therapeutic use*
D004791:Enzyme Inhibitors; D014662:Vasoconstrictor Agents; D019323:omega-N-Methylarginine; D009569:Nitric Oxide; D009638:Norepinephrine