| Prolonged infusion of varied doses of dopexamine hydrochloride for low cardiac output after cardiac surgery. | |
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MedLine Citation:
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PMID: 1358247 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Circulatory failure after cardiac surgery often calls for active hemodynamic management with fluids, inotropes, and vasodilators. Dopexamine hydrochloride is a new combined beta 2-adrenergic and DA1-dopaminergic receptor agonist and an inhibitor of the uptake-1 mechanism of endogenous catecholamines. As a result, it exerts inotropic and vasodilator effects on the heart and systemic vasculature. The effects were examined over a mean of 22 hours, using 1 to 4 micrograms/kg/min of dopexamine to treat low cardiac output states following coronary bypass and valvular/ventricular repair surgery. In 8 out of 14 patients, low cardiac output was readily reversed by 1 microgram/kg/min of dopexamine. Six patients required higher doses (2 to 4 micrograms/kg/min) to achieve a satisfactory cardiac index. Significant changes from control values were observed throughout the infusion for heart rate (67 to 102 beats/min), cardiac index (2.0 to 3.4 L/min/m2), and systemic vascular resistance (1,545 to 914 dyne.s.cm-5). Pulmonary vascular resistance, pulmonary artery wedge pressure, and right atrial pressure were also significantly reduced during the infusion. Most of these changes reversed when dopexamine was discontinued, suggesting a drug-specific effect and a lack of tolerance. Nausea was a frequent complaint, but was no more frequent than in a random sample of similar patients. Titration of dopexamine, 1 to 4 micrograms/kg/min, was efficacious in producing circulatory improvement in patients with a low cardiac output after cardiac surgery. |
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Authors:
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F W Santman |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of cardiothoracic and vascular anesthesia Volume: 6 ISSN: 1053-0770 ISO Abbreviation: J. Cardiothorac. Vasc. Anesth. Publication Date: 1992 Oct |
Date Detail:
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Created Date: 1992-12-02 Completed Date: 1992-12-02 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9110208 Medline TA: J Cardiothorac Vasc Anesth Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 568-72 Citation Subset: IM |
Affiliation:
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Department of Intensive Care, University Hospital Nijmegen, The Netherlands. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic Agonists
/
administration & dosage,
adverse effects,
therapeutic use* Adult Aged Blood Pressure / drug effects Cardiac Output / drug effects Cardiac Output, Low / drug therapy* Cardiac Surgical Procedures* Dopamine / administration & dosage, adverse effects, analogs & derivatives*, therapeutic use Female Heart Rate / drug effects Humans Infusions, Intravenous Male Middle Aged Prospective Studies Pulmonary Artery / physiology Pulmonary Wedge Pressure / drug effects Stroke Volume / drug effects Time Factors Vascular Resistance / drug effects Vasodilator Agents / administration & dosage, adverse effects, therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic Agonists; 0/Vasodilator Agents; 86197-47-9/dopexamine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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