Document Detail

Pharmacologic and mechanical methods of discontinuing extracorporeal circulation in patients with heart failure.
MedLine Citation:
PMID:  8471744     Owner:  NLM     Status:  MEDLINE    
Separation from EC requires simultaneous optimal manipulation of heart rate and rhythm, loading conditions, afterload, and contractility. Patients with preexisting ventricular dysfunction will have alterations in beta-adrenergic receptors and responsiveness to catecholamines, but patients with previously normal ventricular function can also develop ventricular dysfunction. Catecholamines, by stimulating beta-adrenergic receptors, decrease systolic function to allow separation from EC. The phosphodiesterase inhibitors provide both inotropic support and vasodilation, to improve both systolic and diastolic function. When administered in combination, catecholamines and cyclic-AMP-specific phosphodiesterase inhibitors can have additive effects to restore beta 1-adrenergic responsiveness. Combination therapy provides an important support during biventricular dysfunction and facilitates separation from EC. Finally, mechanical support provides a therapeutic option when pharmacologic therapy is ineffective.
J H Levy
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  7     ISSN:  1053-0770     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  1993 Apr 
Date Detail:
Created Date:  1993-05-17     Completed Date:  1993-05-17     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:  12-7     Citation Subset:  IM; S    
Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA 30322.
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MeSH Terms
Cardiac Output, Low / drug therapy*,  physiopathology,  therapy*
Extracorporeal Circulation*
Heart Failure / drug therapy*,  physiopathology,  therapy*
Ventricular Function / physiology
Erratum In:
J Cardiothorac Vasc Anesth 1993 Aug;7(4):511

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

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