| Specific afterload reduction with parenteral hydralazine following cardiac surgery. | |
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MedLine Citation:
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PMID: 459526 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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R N Sladen; M H Rosenthal |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 1979-09-25 Completed Date: 1979-09-25 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 195-202 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Aged Cardiac Output / drug effects Cardiac Surgical Procedures* Female Hemodynamics / drug effects* Humans Hydralazine / administration & dosage, therapeutic use* Injections, Intravenous Male Middle Aged Myocardial Contraction / drug effects Postoperative Complications / prevention & control Postoperative Period Shock, Cardiogenic / prevention & control* Stroke Volume / drug effects Vascular Resistance / drug effects Vasodilation* |
| Chemical | |
Reg. No./Substance:
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86-54-4/Hydralazine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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