Document Detail

Amrinone versus dopamine-nitroglycerin after reconstructive surgery for complete atrioventricular septal defect.
MedLine Citation:
PMID:  9412887     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To compare the effectiveness and safety of amrinone and a combination of dopamine and nitroglycerin in infants after reconstructive surgery for congenital heart disease. DESIGN: A prospective, randomized, double-blind study. SETTING: Pediatric intensive care unit in a university hospital. PARTICIPANTS: Thirty-two infants with complete atrioventricular septal defect. INTERVENTIONS: Amrinone loading dose, 2 mg/kg, followed by a maintenance infusion, 7.5 micrograms/kg/min, was given to 17 infants before separation from cardiopulmonary bypass. The remaining 15 patients received a combination of dopamine, 5 micrograms/kg/min, and nitroglycerin, 1 microgram/kg/min. MEASUREMENTS AND MAIN RESULTS: The circulatory state of the patients was evaluated from 4 to 18 hours after cardiopulmonary bypass. The systemic blood flow index, calculated using the Fick principle, was higher in the amrinone group (2.5 +/- 0.7 L/min/m2) compared with the dopamine-nitroglycerin group (2.0 +/- 0.6 L/min/m2, mean +/- SD). The pulmonary blood flow index in the amrinone group was higher (2.9 +/- 0.6 L/min/m2) than in the dopamine-nitroglycerin group (2.2 +/- 0.6 L/min/m2); no significant difference was noted in the mean pulmonary artery pressure. The oxygen extraction ratio was higher in the dopamine-nitroglycerin group (0.41 +/- 0.07) compared with the amrinone group (0.34 +/- 0.08). Despite lower platelet counts in the amrinone group, no hemorrhagic complications were seen in any patient. CONCLUSIONS: With this dosage regimen, amrinone provides a higher cardiac output, more favorable oxygen dynamics, and lower pulmonary vascular resistance than dopamine and nitroglycerin.
P Laitinen; J M Happonen; H Sairanen; K Peltola; P Rautiainen; R Korpela; M Leijala
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  11     ISSN:  1053-0770     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  1997 Dec 
Date Detail:
Created Date:  1998-01-29     Completed Date:  1998-01-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  870-4     Citation Subset:  IM    
Department of Anesthesiology, Hospital for Children and Adolescents, University of Helsinki, Finland.
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MeSH Terms
Amrinone / pharmacology*
Dopamine / pharmacology*
Double-Blind Method
Heart Septal Defects / surgery*
Hemodynamics / drug effects*
Infant, Newborn
Nitroglycerin / pharmacology*
Prospective Studies
Vasodilator Agents / pharmacology*
Reg. No./Substance:
0/Vasodilator Agents; 55-63-0/Nitroglycerin; 60719-84-8/Amrinone

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

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