Vincent J L, Léon M, Berré J, Mélot C, Kahn R J
Department of Intensive Care, Erasme University Hospital, Free University of Brussels, Belgium.
Crit Care Med. 1992 Aug;20(8):1102-6. doi: 10.1097/00003246-199208000-00006.
To assess the hemodynamic effects of the addition of small bolus doses of the phosphodiesterase inhibitor enoximone to adrenergic therapy in patients with severe heart failure.
Open label, prospective study.
Multidisciplinary department of intensive care in a university academic hospital.
Twelve surgical patients after cardiac surgery and ten medical patients with ischemic or dilated cardiomyopathy who had signs of altered tissue perfusion associated with a low cardiac index (less than 2.25 L/min/m2), despite adrenergic therapy.
Small iv bolus doses of 0.25 mg/kg of enoximone.
This treatment resulted in significant increases in cardiac index and left ventricular stroke work index without significant changes in heart rate or mean arterial pressure. Furthermore, the effects of half this dose (i.e., 0.125 mg/kg), studied in 11 patients, demonstrated a significant drug-induced increase in mean (+/- SD) cardiac index (from 1.58 +/- 0.29 to 1.84 +/- 0.27 L/min/m2, p less than .01) without change in mean arterial pressure (from 74.5 +/- 12.1 to 76.5 +/- 12.6 mm Hg, nonsignificant).
Direct iv injections of enoximone can significantly increase the cardiac index in critically ill patients treated by adrenergic agents for severe heart failure. The administration of small doses of enoximone is effective and has minimal effect on arterial pressure.
评估在严重心力衰竭患者的肾上腺素能治疗中添加小剂量推注磷酸二酯酶抑制剂依诺昔酮的血流动力学效应。
开放标签的前瞻性研究。
一所大学学术医院的多学科重症监护科。
12例心脏手术后的外科患者和10例患有缺血性或扩张型心肌病的内科患者，尽管接受了肾上腺素能治疗，但仍有与低心指数（低于2.25L/min/m²）相关的组织灌注改变迹象。
静脉推注小剂量0.25mg/kg的依诺昔酮。
该治疗使心指数和左心室每搏功指数显著增加，而心率或平均动脉压无显著变化。此外，在11例患者中研究了该剂量一半（即0.125mg/kg）的效果，结果显示药物引起平均（±标准差）心指数显著增加（从1.58±0.29增至1.84±0.27L/min/m²，p<0.01），而平均动脉压无变化（从74.5±12.1至76.5±12.6mmHg，无显著意义）。
直接静脉注射依诺昔酮可使接受肾上腺素能药物治疗的严重心力衰竭重症患者的心指数显著增加。小剂量依诺昔酮给药有效且对动脉压影响最小。
