Quantitative Assessment of the Effects of ‘Inodilators’ on the Myocardium in Patients without Primary Cardiac Insufficiency after Coronary Surgery: Part I - Amrinone
| Autor: | C. Engel, Pp Lunkenheimer, H Isringhaus, O Peterschmidt, Klaus Redmann, Willem Flameng, G Rettig, A Geiger |
|---|---|
| Rok vydání: | 1991 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Inotrope medicine.medical_specialty Cardiac output Cardiac Output Low Hemodynamics Amrinone Internal medicine Heart rate medicine Humans Enoximone Postoperative Period Coronary Artery Bypass Aged business.industry Middle Aged Myocardial Contraction Stimulation Chemical Anesthesia Cardiology Female Surgery Dobutamine Isosorbide dinitrate Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | The Thoracic and Cardiovascular Surgeon. 39:123-128 |
| ISSN: | 1439-1902 0171-6425 |
| DOI: | 10.1055/s-2007-1013947 |
| Popis: | The positive inotropic and peripheral vasodilating effect of amrinone has been measured in 20 patients without manifest cardiac insufficiency during the early (8-18 h postoperative) and late (18-48 h postoperative) recovery phase after coronary surgery. On conclusion of the surgical intervention first the aortocoronary bypass flow was compared during dobutamine and amrinone administration. It increased by 88% with amrinone and by 19% with dobutamine. Then a needle force probe was implanted in the myocardium. Directly measured local myocardial force increased not significantly by 3.5% after the first and by 5.1% after the second bolus injection of 2 mg/kg amrinone. The rate of myocardial contraction increased by 18.7% and 12%. The rate of relaxation decreased by 5.3% after the first and increased by 15% after the second injection. Mean pulmonary arterial pressure fell from 18.5 to 15.5 mmHg and from 19.7 to 17 mmHg. Cardiac output increased by 23% after the first and by 20% after the second injection. Heart rate rose from 88 to 99 bpm and from 86 to 94 bpm. Total peripheral resistance fell from 1,035 to 706 dyn*s*cm-5 and from 1,036 to 819 dyn*s*cm-5. The systolic arterial pressure fell from 132 to 116 mmHg after the first injection and did not change after the second injection. Amrinone was found to be a powerful peripheral vasodilator with a mild positive inotropic action. The variations in the effects between the early and late recovery phases mainly reflect a progressive haemodynamic stabilization with a decreasing tendency toward hypotensive disregulation. Careful consideration has to be paid to a properly balanced filling of the vascular system before administering amrinone. |
| Databáze: | OpenAIRE |
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