Document Detail


The hemodynamic effect of phentolamine and dobutamine after open-heart operations in children: influence of the underlying heart defect.
MedLine Citation:
PMID:  6860008     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The hemodynamic effects of phentolamine alone and in combination with dobutamine were studied in the immediate postoperative period in two groups of children. Group 1 (N = 6; mean age, 152 months) had open-heart operation for acquired mitral valve disease. Group 2 (N = 6; mean age, 60 months) had intracardiac repair for tetralogy of Fallot. Before drug administration, cardiac index did not differ between groups, but patients with tetralogy of Fallot had a higher heart rate and smaller stroke volume index; systemic vascular resistance was high in both groups. With phentolamine (10 micrograms/kg/min), cardiac index and stroke volume index increased similarly in both groups (+ 13% for cardiac index in Group 1, +9% in Group 2), while systemic vascular resistance, pulmonary vascular resistance, and pulmonary wedge pressure decreased. When dobutamine (5 micrograms/kg/min) was added, there was a further increase in cardiac index in both groups, but it was greater in Group 1 (+17% vs +12%, p less than 0.01, compared with phentolamine alone; +33% vs +22%, p less than 0.01, compared with control). Systemic vascular resistance remained unchanged and heart rate increased in both groups, so that the left ventricular stroke work index increased. Although stroke volume index increased significantly with dobutamine in Group 1 (+11%, p less than 0.01), it remained unchanged in Group 2 (+3%, not significant). Thus in Group 2, dobutamine increased cardiac index only by increasing heart rate. This suggests that the relatively small, noncompliant left ventricle in patients with tetralogy of Fallot cannot further respond to inotropic drugs by increasing stroke volume index.
Authors:
M Berner; J C Rouge; B Friedli
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  35     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1983 Jun 
Date Detail:
Created Date:  1983-07-08     Completed Date:  1983-07-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  643-50     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Catecholamines / pharmacology*
Child
Dobutamine / pharmacology*
Heart Rate / drug effects
Heart Valve Diseases / surgery
Hemodynamics / drug effects*
Humans
Mitral Valve / surgery*
Phentolamine / pharmacology*
Pulmonary Wedge Pressure / drug effects
Stroke Volume / drug effects
Tetralogy of Fallot / surgery*
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
0/Catecholamines; 34368-04-2/Dobutamine; 50-60-2/Phentolamine

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


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