| Arginine vasopressin is an ideal drug after cardiac surgery for the management of low systemic vascular resistant hypotension concomitant with pulmonary hypertension. | |
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MedLine Citation:
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PMID: 17704123 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Low systemic vascular resistance (SVR) hypotension concomitant with pulmonary hypertension (PH) is difficult to manage postoperatively because they are often catecholamine-resistant. So, we applied arginine vasopressin (AVP), which is a potent vasoconstrictor in a specific condition, for post-cardiotomy refractory low SVR hypotension concomitant with PH. We treated nine cases of postoperative refractory vasodilatory hypotension concomitant with PH even after conventional treatment that included nitric oxide inhalation and/or intraaortic balloon pump. AVP was administrated with 0.05 approximately 0.1 U/min intravenously. After AVP administration, the mean systemic arterial pressure increased from 47.3+/-9.5 to 76.5+/-12.2 mmHg (P<0.01) and SVR increased from 488.1+/-92.7 to 1188+/-87 dynes x s x cm(-5) (P<0.01). Fortunately, even though the cardiac index decreased, it remained in a normal range. Alteration in the PVR was not significant, but the Pp/Ps became somewhat lower (0.66+/-0.2 to 0.47+/-0.16, P<0.01). AVP increased the urine output and improved oxygenation. AVP improved systemic circulation (increased systemic blood pressure with maintaining cardiac output) without deterioration of pulmonary hypertension. AVP is an ideal drug for treating refractory low SVR hypotension concomitant with PH. But its indication must be limited. |
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Authors:
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Eiki Tayama; Tomohiro Ueda; Takahiro Shojima; Koji Akasu; Takeshi Oda; Shuji Fukunaga; Hidetoshi Akashi; Shigeaki Aoyagi |
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Publication Detail:
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Type: Journal Article Date: 2007-08-17 |
Journal Detail:
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Title: Interactive cardiovascular and thoracic surgery Volume: 6 ISSN: 1569-9285 ISO Abbreviation: Interact Cardiovasc Thorac Surg Publication Date: 2007 Dec |
Date Detail:
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Created Date: 2007-11-27 Completed Date: 2007-12-19 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101158399 Medline TA: Interact Cardiovasc Thorac Surg Country: England |
Other Details:
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Languages: eng Pagination: 715-9 Citation Subset: IM |
Affiliation:
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Department of Surgery, Kurume University Hospital, 67 Asahi-machi, Kurume City, 830-0011, Japan. eiki@med.kurume-u.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Arginine Vasopressin / administration & dosage, therapeutic use* Blood Pressure / drug effects Cardiac Output / drug effects Cardiac Surgical Procedures / adverse effects* Female Humans Hypertension, Pulmonary / complications*, physiopathology Hypotension / complications, drug therapy*, etiology, physiopathology Infusions, Intravenous Male Middle Aged Retrospective Studies Treatment Outcome Vascular Resistance* Vasoconstrictor Agents / administration & dosage, therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Vasoconstrictor Agents; 113-79-1/Arginine Vasopressin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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