Document Detail

Specific afterload reduction with parenteral hydralazine following cardiac surgery.
MedLine Citation:
PMID:  459526     Owner:  NLM     Status:  MEDLINE    
In a group of seven patients who had had cardiac operations, intravenous (IV) hydralazine was used to provide afterload reduction in situations of severe left ventricular dysfunction. Despite fluid loading, inotropic support with dopamine, and afterload reduction with sodium nitroprusside, the patients had persistent states of low cardiac output and high systemic vascular resistance. Administration of sodium nitroprusside was limited by its effect on preload and blood pressure, so that it necessitated frequent fluid challenges. The addition of IV hydralazine to this regimen caused a mean increase of 44.7% in the stroke index and a mean reduction of 28.6% in systemic vascular resistance without significant change in pulmonary artery wedge pressure, mean arterial pressure, or heart rate. Rapid weaning of sodium nitroprusside and, on occasion, dopamine was facilitated. Frequent fluid challenges to restore preload were unnecessary. Dose requirements of hydralazine were small: 2.5 to 5.0 mg IV initially, and then a maintenance dose of 2.5 to 7.5 mg IV every 4 to 6 hours. These preliminary clinical observations indicate that in patients with low cardiac output--high resistance states and normal or elevated preload, the important benefit of specific afterload reduction may be provided by parenteral hydrolazine in the early period following cardiac surgery. Prospective, controlled studies with this agent in this situation appear warranted.
R N Sladen; M H Rosenthal
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  78     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1979 Aug 
Date Detail:
Created Date:  1979-09-25     Completed Date:  1979-09-25     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:  195-202     Citation Subset:  AIM; IM    
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MeSH Terms
Administration, Oral
Cardiac Output / drug effects
Cardiac Surgical Procedures*
Hemodynamics / drug effects*
Hydralazine / administration & dosage,  therapeutic use*
Injections, Intravenous
Middle Aged
Myocardial Contraction / drug effects
Postoperative Complications / prevention & control
Postoperative Period
Shock, Cardiogenic / prevention & control*
Stroke Volume / drug effects
Vascular Resistance / drug effects
Reg. No./Substance:

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

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