Document Detail


Perioperative enoximone infusion improves cardiac enzyme release after CABG.
MedLine Citation:
PMID:  15365919     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess whether routine postoperative enoximone infusion compared with dobutamine improved clinical and biochemical results after coronary artery bypass grafting with cardiopulmonary bypass. DESIGN: Prospective nonrandomized study. Data collection was blinded to the choice of inotrope. SETTING: Double-institutional clinical investigation. PARTICIPANTS: Two hundred sixteen consecutive patients undergoing myocardial revascularization between May 2000 and December 2002. INTERVENTIONS: Seventy-two patients underwent myocardial revascularization and were treated with enoximone, 5 microg/kg/min (group A). They were compared in a ratio of 1:2 to 144 patients treated with dobutamine at the same dose (group B) after aortic cross-clamp removal. The groups proved to be homogenous in preoperative and intraoperative characteristics. MEASUREMENTS and MAIN RESULTS: Hospital outcome, electrocardiogram, echocardiography, further inotropic support, and biochemical markers of ischemia were compared. Subsets of patients with comorbidities and total arterial revascularization were analyzed. Perioperative myocardial infarction, postoperative low-output syndrome, intra-aortic balloon pump, atrial fibrillation, ST-segment changes, postoperative echocardiographic findings, and intensive care and hospital durations were similar between groups. In the postoperative course, more patients belonging to group A maintained low-dose inotropic support, whereas more patients belonging to group B required higher doses. Troponin I and creatine kinase-MB values were higher in patients of group B, especially when subgroups with diabetes, left ventricular hypertrophy, or total arterial revascularization were included. CONCLUSION: Postoperative enoximone reduced troponin I release and need for inotropic support in patients undergoing on-pump myocardial revascularization. Subgroup data were confirmed in diabetes, left ventricular hypertrophy, and total arterial revascularization.
Authors:
Francesco Onorati; Attilio Renzulli; Marisa De Feo; Nicola Galdieri; Pasquale Santè; Pasquale Mastroroberto; Massimo Bilotta; Maurizio Cotrufo
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Multicenter Study    
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  18     ISSN:  1053-0770     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-09-14     Completed Date:  2005-02-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  409-14     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic and Respiratory Sciences, Second University of Naples, Italy. frankono@libero.it
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MeSH Terms
Descriptor/Qualifier:
Cardiopulmonary Bypass
Cardiotonic Agents / administration & dosage*
Coronary Artery Bypass*
Creatine Kinase / blood
Creatine Kinase, MB Form
Dobutamine / administration & dosage
Electrocardiography
Enoximone / administration & dosage*
Female
Humans
Infusions, Intravenous
Isoenzymes / blood
Male
Middle Aged
Myocardium / enzymology*
Postoperative Care
Postoperative Complications
Troponin I / blood
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Isoenzymes; 0/Troponin I; 34368-04-2/Dobutamine; 77671-31-9/Enoximone; EC 2.7.3.2/Creatine Kinase; EC 2.7.3.2/Creatine Kinase, MB Form

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


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