Comparison of the hemodynamic effects of amrinone in patients who required low-to-moderate-dose and high-dose catecholamines after cardiac valve replacement
| Autor: | Daisuke Yoshikawa, Yukitaka Isa, Susumu Ishikawa, Fumio Kunimoto, Fumio Goto, Hiroshi Koyama, Satoshi Ohki, Hiroshi Tsukagoshi |
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| Rok vydání: | 1999 |
| Předmět: |
Adult
Male Cardiac function curve Cardiotonic Agents Dopamine Cardiac index Hemodynamics Critical Care and Intensive Care Medicine Loading dose Amrinone Dobutamine medicine Humans Postoperative Period Prospective Studies Infusions Intravenous Aged Heart Valve Prosthesis Implantation Analysis of Variance Dose-Response Relationship Drug business.industry Middle Aged medicine.anatomical_structure Blood pressure Catheterization Swan-Ganz Anesthesia Vascular resistance Female business Muscle Contraction medicine.drug |
| Zdroj: | Critical Care Medicine. 27:2698-2702 |
| ISSN: | 0090-3493 |
| DOI: | 10.1097/00003246-199912000-00016 |
| Popis: | Objectives To determine hemodynamic response to amrinone in patients after cardiac surgery, in relation to the postoperative cardiac function, which was indicated by the required doses of catecholamines. Design Prospective clinical study. Setting Surgical intensive care unit in a university hospital. Patients Fourteen patients who required a low-to-moderate dose of dopamine and dobutamine (group L) and 14 patients who required a high dose of dopamine and dobutamine (group H) after cardiac valve replacement. Interventions A loading dose of amrinone (0.75 mg/kg) was administered during a 15-min period and the continuous infusion was followed incrementally by doses of 5, 10, and 20 microg/kg/min every 60 mins on the first postoperative day. Measurements and main results Hemodynamic variables were determined by the radial and pulmonary artery catheters at a dose of 0, 5, 10, and 20 microg/kg/min. Two-way repeated-measures analysis of variance showed significant interaction in the two groups in cardiac index and mean systemic arterial pressure. Cardiac index increased in a dose-dependent manner in group L but was unchanged in group H. Systemic vascular resistance index decreased in a dose-dependent manner in both groups. The mean systemic arterial pressure decreased in group L at a dose of 5 microg/kg/min and returned to the baseline level at doses of 10 and 20 microg/kg/min. On the other hand, the mean systemic arterial pressure significantly decreased in group H at a dose of 20 microg/kg/min. Conclusions The inotropic effects of amrinone after cardiac valve replacement may be associated with the postoperative myocardial reserve, which was indicated by the required doses of catecholamines, although a similar vasodilative effect was observed in both groups. |
| Databáze: | OpenAIRE |
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