| The effects of vasoactive agents on flow through saphenous vein grafts during lower-extremity peripheral vascular surgery. | |
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MedLine Citation:
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PMID: 17544884 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: The purpose of this study was to assess the effects of hemodynamic alterations on vein graft flow during peripheral vascular surgery. It was hypothesized that vasopressors can be administered without compromising flow through the vein grafts. SETTING: Tertiary care center, university medical center. Study DESIGN: Randomized placebo-controlled double-blinded study. METHODS: The effects of phenylephrine, epinephrine, milrinone, intravenous fluid, and placebo on newly constructed peripheral vein grafts were assessed in 60 patients (12 patients in each of 5 groups). Systemic and central hemodynamics were measured by using intra-arterial and pulmonary artery catheters. Vein graft flow was measured by using a transultrasonic flow probe (Transultrasonic Inc, Ithaca, NY). RESULTS: Phenylephrine increased systemic mean blood pressure (mBP) (68.2-94.0 mmHg, p < 0.01), systemic vascular resistance (SVR) (1,091-1,696 dynes x sec x cm(-5), p < 0.001), and vein graft flow (39.5-58.9 mL/min, p < 0.01), whereas cardiac output remained unchanged. Epinephrine resulted in increased cardiac output (4.4-6.9 L/min, p < 0.01) and mBP (72.7-89.1 mmHg, p < 0.01), whereas vein graft flow was reduced in 6 of 12 patients. Intravenous fluid administration resulted in a relatively smaller increase in graft flow (37.6-46.0 mL/min, p < 0.05), an increase in cardiac output, and an insignificant decrease in SVR. Other treatments had either little or no effect on vein graft flow. CONCLUSION: The study hypothesis was partly supported. Although both phenylephrine and epinephrine increased blood pressure, only the former increased vein graft flow in all patients. In conjunction with increases in graft flow after fluid administration, these data suggest that factors affecting vein graft flow are not just simply related to systemic hemodynamics. |
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Authors:
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Andrew D Maslow; Arthur Bert; Jeffrey Slaiby; William Carney; Edward Marcaccio |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial Date: 2007-04-19 |
Journal Detail:
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Title: Journal of cardiothoracic and vascular anesthesia Volume: 21 ISSN: 1053-0770 ISO Abbreviation: J. Cardiothorac. Vasc. Anesth. Publication Date: 2007 Jun |
Date Detail:
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Created Date: 2007-06-04 Completed Date: 2007-08-09 Revised Date: - |
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: 344-50 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, Rhode Island Hospital, Providence, RI, USA. amaslow@rcn.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Blood Pressure / drug effects Cardiac Output / drug effects Double-Blind Method Epinephrine / pharmacology Humans Lower Extremity / blood supply* Middle Aged Milrinone / pharmacology Peripheral Vascular Diseases / surgery* Phenylephrine / pharmacology Regional Blood Flow / drug effects* Saphenous Vein / transplantation* Vascular Resistance / drug effects |
| Chemical | |
Reg. No./Substance:
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51-43-4/Epinephrine; 59-42-7/Phenylephrine; 78415-72-2/Milrinone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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