| Use of esmolol in hypertension after cardiac surgery. | |
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MedLine Citation:
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PMID: 2864849 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Systolic hypertension, which is common soon after cardiac surgery, increases cardiac work and may threaten fresh vascular anastomoses. Because postoperative hypertension is often associated with elevated catecholamines and preoperative use of beta-blocking agents, esmolol, an ultrashort-acting beta-blocking agent, was compared with nitroprusside in a crossover study in this setting. Twelve patients, 18 to 28 hours after cardiac surgery (coronary artery bypass graft in 9, aortic valve replacement in 2 and valved aortic conduit with reimplantation of coronary arteries in 1 patient) received controlled infusions of esmolol (mean dosage 142 +/- 100 micrograms/kg/min, range 50 to 300 micrograms/kg/min) and nitroprusside (mean dose 1.6 +/- 1.3 micrograms/kg/min, range 0.5 to 2.75 micrograms/kg/min). In this open-label study, choice of the first drug was randomized, after which patients were then crossed over to the other study drug. Therapeutic response (greater than or equal to 15% systolic blood pressure reduction) was achieved in 11 of 12 esmolol patients and 12 of 12 nitroprusside patients. Both drugs significantly lowered systolic and diastolic blood pressure, as well as left ventricular stroke work index. While the cardiac index was decreased by esmolol and increased by nitroprusside, neither drug significantly changed stroke volume index. Systemic vascular resistance, unchanged by esmolol, was decreased significantly by nitroprusside. Oxygen saturation and Pao2, unchanged with esmolol, were both significantly reduced with nitroprusside. Thus, for hypertension early after cardiac surgery, esmolol is safe, effective and rapid and, compared with nitroprusside, results in less unwanted decrease in diastolic blood pressure and oxygen saturation, but there is more decrease in heart rate and cardiac index. |
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Authors:
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R J Gray; T M Bateman; L S Czer; C Conklin; J M Matloff |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: The American journal of cardiology Volume: 56 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1985 Oct |
Date Detail:
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Created Date: 1985-11-19 Completed Date: 1985-11-19 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 49F-56F 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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Adrenergic beta-Antagonists
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adverse effects,
therapeutic use* Adult Aged Drug Administration Schedule Female Heart Diseases / complications, surgery* Hemodynamics / drug effects Humans Hypertension / drug therapy*, etiology Male Middle Aged Nitroprusside / therapeutic use Postoperative Complications Propanolamines / adverse effects, therapeutic use* Random Allocation |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Propanolamines; 15078-28-1/Nitroprusside; 84057-94-3/esmolol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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