Management of the cardiac risk patient
| Autor: | Johann Motsch |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Bradycardia
Tachycardia medicine.medical_specialty business.industry Adrenergic medicine.disease Clonidine Cardiac surgery Coronary artery disease Mivazerol chemistry.chemical_compound Anesthesiology and Pain Medicine chemistry Internal medicine Anesthesia Cardiology Medicine Dexmedetomidine medicine.symptom business medicine.drug |
| Zdroj: | Best Practice & Research Clinical Anaesthesiology. 14:369-380 |
| ISSN: | 1521-6896 |
| Popis: | Surgery-induced hyperdynamic cardiac responses compromise the myocardial oxygen supply ratio. Patients with coronary artery disease are therefore at risk of peri-operative myocardial ischaemia, which may result in an adverse cardiac outcome. A predominant effect of α 2 -adrenergic drugs is a modulation of the central sympathetic tone, thereby preventing catecholamine release, hypertension and tachycardia. The protective cardiac and anti-ischaemic effects of α 2 -adrenergic agonists are well documented in animals. Cardiac surgery and vascular surgery patients were studied using clonidine, mivazerol and dexmedetomidine. There is good evidence that, in humans, α 2 -agonists protect the heart at risk of peri-operative ischaemia, especially in high-stimulation phases intra-operatively and post-operatively. The greatest benefit of peri-operative therapy with α 2 -adrenergic agonists is documented for vascular surgery patients. Besides their anti-ischaemic effect, clonidine and dexmedetomidine are associated with a greater need for intervention to treat hypotension and bradycardia. |
| Databáze: | OpenAIRE |
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