Document Detail


Effects of vasoactive drugs on flows through left internal mammary artery and saphenous vein grafts in man.
MedLine Citation:
PMID:  1682533     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Vasoactive agents are commonly used in the postcardiopulmonary bypass period to elevate the mean arterial pressure of myocardial revascularization patients. Concern exists that administration of vasoactive agents in this setting may affect flow through saphenous vein and internal mammary artery grafts. Twenty-eight patients were randomly assigned to receive one of the six two-drug combinations of phenylephrine, norepinephrine, and epinephrine. After termination of cardiopulmonary bypass baseline, hemodynamic measurements and electromagnetic flow probe measurements of saphenous vein and internal mammary artery graft flow were made. The first agent was then infused to elevate mean arterial pressure 20 mm Hg. After 5 minutes of stability, hemodynamic and graft flow measurements were repeated. The infusion was terminated, 5 minutes of stability were obtained, and baseline measurements were repeated. The second agent was then infused, and measurements were repeated after a 5-minute stabilization period. Phenylephrine induced a nonsignificant increase in saphenous vein graft flow (68 +/- 31 versus 81 +/- 49 ml/min) and a significant decrease in internal mammary artery graft flow (40 +/- 16 versus 32 +/- 12 ml/min). Norepinephrine induced a significant increase in saphenous vein graft flow (80 +/- 39 versus 97 +/- 39 ml/min) and no significant change in internal mammary artery graft flow (44 +/- 20 versus 45 +/- 20 ml/min). Epinephrine induced a significant increase in both saphenous vein (82 +/- 38 versus 96 +/- 40 ml/min) and internal mammary artery (38 +/- 12 versus 55 +/- 24 ml/min) graft flows. We conclude that administration of vasoactive agents in the postcardiopulmonary bypass period may significantly affect saphenous vein and internal mammary artery graft flows.
Authors:
J A DiNardo; A Bert; M J Schwartz; R G Johnson; R L Thurer; R M Weintraub
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  102     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1991 Nov 
Date Detail:
Created Date:  1991-12-04     Completed Date:  1991-12-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  730-5     Citation Subset:  AIM; IM    
Affiliation:
Charles A. Dana Research Institute of Beth Israel Hospital, Boston, Mass.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic alpha-Agonists / pharmacology*
Epinephrine / pharmacology
Female
Hemodynamics / drug effects
Humans
Male
Mammary Arteries / drug effects*
Middle Aged
Myocardial Revascularization
Norepinephrine / pharmacology
Phenylephrine / pharmacology
Postoperative Period
Random Allocation
Regional Blood Flow / drug effects
Saphenous Vein / drug effects*,  transplantation*
Chemical
Reg. No./Substance:
0/Adrenergic alpha-Agonists; 51-41-2/Norepinephrine; 51-43-4/Epinephrine; 59-42-7/Phenylephrine

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


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