Document Detail


Alpha-adrenergic agonist drugs, left ventricular function, and emergency from cardiopulmonary bypass.
MedLine Citation:
PMID:  1983407     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The relationship between preoperative left ventricular (LV) dysfunction and the use of alpha-adrenoceptor agonists during weaning from cardiopulmonary bypass was studied in 102 patients undergoing coronary artery surgery. LV function was evaluated subjectively by examination of the 30 degree right anterior oblique left ventriculogram. Group 1 consisted of 75 patients with normal or mild impairment in LV function, whereas group 2 consisted of 27 patients with moderate-severe LV dysfunction. Cardiovascular parameters were measured at baseline, during hypothermic bypass with the aorta clamped, during normothermic bypass after unclamping, and 1 and 15 minutes after separation from bypass. Thirty-seven patients in group 1 (49%) and 11 patients in group 2 (39%) required some form of inotropic and/or vasopressor support during weaning from bypass. Group 2 required significantly higher cumulative doses of phenylephrine after bypass compared with group 1 (1.69 +/- 0.70 mg, n = 9, v 0.24 +/- 0.04 mg, n = 27, P less than 0.05). Similarly, the dose of norepinephrine infusion in group 2 was 3.3 times that in group 1 (10 +/- 6 micrograms/min, n = 2, v 3 +/- 0.6 micrograms/min, n = 2, P = NS). The higher doses of alpha-adrenoceptor agonists required in patients with moderate-severe LV dysfunction may be due to differences in alpha-adrenoceptor agonist affinity and/or receptor density.
Authors:
C E Smith; T L Higgins; E J Kraenzler; N J Starr; J P Coyle; M G Licina; J Blum
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiothoracic anesthesia     Volume:  4     ISSN:  0888-6296     ISO Abbreviation:  J Cardiothorac Anesth     Publication Date:  1990 Dec 
Date Detail:
Created Date:  1991-12-31     Completed Date:  1991-12-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8709732     Medline TA:  J Cardiothorac Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  681-6     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Anesthesia, Cleveland Clinic Foundation, OH.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic alpha-Agonists / therapeutic use*
Blood Pressure / drug effects,  physiology
Calcium Chloride / administration & dosage,  therapeutic use
Cardiopulmonary Bypass*
Coronary Artery Bypass*
Dobutamine / administration & dosage,  therapeutic use
Female
Humans
Male
Middle Aged
Myocardial Contraction / drug effects
Myocardial Infarction / physiopathology
Nitroglycerin / therapeutic use
Nitroprusside / therapeutic use
Norepinephrine / administration & dosage,  therapeutic use
Phenylephrine / administration & dosage,  therapeutic use
Time Factors
Vascular Resistance / drug effects,  physiology
Ventricular Function, Left / drug effects,  physiology*
Chemical
Reg. No./Substance:
0/Adrenergic alpha-Agonists; 10043-52-4/Calcium Chloride; 15078-28-1/Nitroprusside; 34368-04-2/Dobutamine; 51-41-2/Norepinephrine; 55-63-0/Nitroglycerin; 59-42-7/Phenylephrine
Comments/Corrections
Comment In:
J Cardiothorac Vasc Anesth. 1991 Oct;5(5):533-5   [PMID:  1932662 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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