Document Detail


Vasodilation with adenosine or sodium nitroprusside after coronary artery bypass surgery: a comparative study on myocardial blood flow and metabolism.
MedLine Citation:
PMID:  8452257     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The effects of adenosine and sodium nitroprusside (SNP) on central hemodynamics and myocardial blood flow and metabolism were investigated postoperatively after elective coronary artery bypass (CABG) surgery in ten sedated and mechanically ventilated patients in the intensive care unit. During three consecutive 15-min periods, SNP (0.8 +/- 0.1 micrograms.kg-1 x min-1), adenosine (88.9 +/- 13.3 micrograms.kg-1 x min-1), and then again SNP (0.7 +/- 0.1 micrograms.kg-1 x min-1) were infused to control postoperative hypertension at a mean arterial pressure of approximately 80 mm Hg. Systemic and pulmonary hemodynamics and global (coronary sinus flow, CSF) as well as regional (great cardiac vein flow, GCVF) myocardial blood flow and metabolic variables were measured. During adenosine infusion, in comparison to SNP, heart rate was unchanged, stroke volume index and cardiac index increased (24% and 32%, respectively), and the systemic vascular resistance index decreased (-26%). Mean pulmonary arterial pressure (24%) as well as pulmonary capillary wedge pressure (27%) and central venous pressure (18%) were higher with adenosine compared to SNP. Adenosine also increased CSF and GCVF (108% and 103%, respectively) without altering the CSF/GCVF flow ratio compared to SNP. Furthermore, adenosine increased the coronary oxygen content (51%) and decreased the arterio-great cardiac vein oxygen content difference (-48%) without changing regional myocardial oxygen consumption, indicating a more pronounced hyperkinetic myocardial circulation compared to SNP. In addition, adenosine infusion decreased arterial PO2 (-11%) and increased the intrapulmonary shunt fraction (57%). The PR interval time of the electrocardiogram was prolonged (12%) and the ST segment was more depressed during adenosine infusion compared to SNP.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
S Zäll; K Kirnö; I Milocco; S E Ricksten
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  76     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  1993 Mar 
Date Detail:
Created Date:  1993-04-09     Completed Date:  1993-04-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  498-503     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesia and Intensive Care, Sahlgren's Hospital, University of Gothenburg, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / therapeutic use*
Coronary Artery Bypass*
Coronary Circulation / drug effects*,  physiology
Female
Humans
Hypertension / drug therapy*,  physiopathology
Male
Middle Aged
Myocardium / metabolism*
Nitroprusside / therapeutic use*
Postoperative Complications / drug therapy*,  physiopathology
Chemical
Reg. No./Substance:
15078-28-1/Nitroprusside; 58-61-7/Adenosine

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


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