Phenylephrine to increase blood flow in the radial artery used as a coronary bypass conduit
| Autor: | Ioanna Apostolidou, Nikolaos J. Skubas, Demetrios G. Lappas, Hendrick B. Barner |
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| Rok vydání: | 2005 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Mean arterial pressure Vasodilator Agents Nicardipine Hemodynamics Blood Pressure Nitroglycerin Phenylephrine Internal medicine medicine.artery medicine Humans Vasoconstrictor Agents Cardiac Output Coronary Artery Bypass Radial artery Cardiopulmonary Bypass business.industry Middle Aged Blood pressure medicine.anatomical_structure Anesthesia Radial Artery cardiovascular system Vascular resistance Cardiology Female Vascular Resistance Surgery Cardiology and Cardiovascular Medicine business Blood Flow Velocity medicine.drug Artery |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 130:687-692 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/j.jtcvs.2005.02.066 |
| Popis: | Objective The radial artery has more smooth muscle in its wall than the other arterial conduits and is known to be vasospastic. Because it is frequently necessary to use vasoconstrictors early after coronary bypass surgery we investigated the effects of phenylephrine on conduit flow in this setting. Methods Thirty patients undergoing coronary artery bypass with all arterial conduits in which the radial artery was used as a T-graft were randomly assigned to receive intravenous infusions of normal saline (n = 10); nitroglycerin, 0.5 μg · kg · min (n = 11); or nicardipine, 0.5 μg · kg · min (n = 9), beginning early in the operation. After discontinuation of cardiopulmonary bypass and achievement of stable hemodynamics, control measurements were obtained, and this was followed by phenylephrine infusion to achieve a 20% increase in mean arterial pressure, after which the measurements were repeated. Results Mean radial artery flow increased similarly in all groups: normal saline, 40% ± 25%; nicardipine, 37% ± 27%; nitroglycerin, 48% ± 36% ( P = .533). Comparable changes occurred in arterial pressure and systemic vascular resistance, whereas the cardiac index remained unchanged. Conclusion Radial artery blood flow increases when the mean arterial pressure is increased with phenylephrine. There was no evidence of a conduit vasoconstrictive effect, which could limit or reduce conduit flow. Vasocontriction with phenylephrine is appropriate to provide adequate perfusion pressure for radial artery grafts. |
| Databáze: | OpenAIRE |
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