Document Detail


Nitroprusside and mitral stenosis.
MedLine Citation:
PMID:  7191224     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The cardiovascular effects of an intravenous nitroprusside infusion were evaluated intraoperatively in seven patients with pure mitral stenosis and seven patients with predominant mitral stenosis. Prior to therapy the adverse hemodynamic consequences of light anesthesia and surgical stimulation were evident in all patients: systemic and/or pulmonary hypertension were present, systemic vascular resistance was twice normal, and cardiac function was depressed. Nitroprusside consistently reduced systemic vascular resistance and systemic arterial as well as pulmonary arterial and wedge pressures, but cardiac index increased only when severe pulmonary hypertension and/or some mitral regurgitation coexisted with mitral stenosis. In the group with predominant mitral stenosis, cardiac index increased from 1.8 to 2.1 L/min/m2 with nitroprusside (p < 0.05). In three individuals who demonstrated severe pulmonary hypertension (one with pure mitral stenosis and two with predominant mitral stenosis), nitroprusside induced an increase of almost 50% in cardiac index and stroke volume. In contrast, patients with pure mitral stenosis and mild pulmonary hypertension showed little change in cardiac index or stroke volume. It is concluded that nitroprusside can safely be used to control systemic or pulmonary hypertension during anesthesia and surgery in patients with mitral stenosis and that if severe pulmonary hypertension and/or mitral regurgitation coexist with mitral stenosis, cardiac function will also improve.
Authors:
J G Stone; P F Hoar; A N Faltas; H J Khambatta
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  59     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  1980 Sep 
Date Detail:
Created Date:  1980-11-25     Completed Date:  1980-11-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  662-5     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Ferricyanides / pharmacology*
Hemodynamics / drug effects*
Humans
Hypertension / drug therapy
Mitral Valve Stenosis / drug therapy,  physiopathology*,  surgery
Nitroprusside / pharmacology*,  therapeutic use
Pulmonary Edema / drug therapy
Grant Support
ID/Acronym/Agency:
GM 09069/GM/NIGMS NIH HHS
Chemical
Reg. No./Substance:
0/Ferricyanides; 15078-28-1/Nitroprusside

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


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