Orellano L, Darwisch M, Dieterich H A, Köllner V
Kerckhoff-Klinik, Bad Nauheim.
Z Kardiol. 1991;80 Suppl 4:53-7.
Low output syndrome sometimes complicates early postoperative states following cardiac surgery. A comparative study of hemodynamic responses to enoximone and dobutamine was carried out in two groups of 20 patients each, during a 22-24 hour postoperative observation period. Enoximone, 1 mg/kg i.v. total dose, was given in the first 20 minutes. The infusion was then reduced to 2-10 micrograms.kg-1.min-1 for the next 22-24 hours. Dobutamine was administered in a dose of 4-7 micrograms.kg-1.min-1 over the same period. After 15 minutes of therapy with enoximone cardiac index increased by 42% (initial value 2.31 +/- 0.34 l/min/m2), after 30 minutes by 50%, after 120 minutes by 65% and after 24 hours by 91% from the initial value. At the same time the pulmonary capillary wedge pressure decreased from the initial value of 15.21 +/- 1.65 mmHg by 20%, 25%, 26% and by 43% (22 hours). After dobutamine cardiac index increased from 2.23 +/- 0.6 l/min/m2 by 30% (15 minutes), 47% (30 minutes), 57% (2 hours) and by 85% (22 hours). The pulmonary capillary wedge pressure decreased from 15.70 +/- 3.14 mmHg by 13% (15 minutes), 17% (30 minutes), 22% (2 hours) and by 43% (22 hours). The enoximone group showed a diminution of systolic arterial pressure of 14% in the first 120 minutes, with a return to initial values after 22 hours. Dobutamine produced an increase in systolic arterial pressure of 23% after 2 hours, maintaining increased values of approximately 20% during the observation period. Heart rate increase slightly in both groups in a similar way.(ABSTRACT TRUNCATED AT 250 WORDS)
低输出量综合征有时会使心脏手术后的早期术后状态变得复杂。在术后22 - 24小时的观察期内,对两组各20例患者进行了依诺昔酮和多巴酚丁胺血流动力学反应的比较研究。依诺昔酮静脉注射总剂量为1mg/kg,在前20分钟给药。然后在接下来的22 - 24小时内将输注速率降至2 - 10微克·千克⁻¹·分钟⁻¹。多巴酚丁胺在同一时期以4 - 7微克·千克⁻¹·分钟⁻¹的剂量给药。依诺昔酮治疗15分钟后心脏指数增加42%(初始值2.31±0.34升/分钟/平方米),30分钟后增加50%,120分钟后增加65%,24小时后比初始值增加91%。同时,肺毛细血管楔压从初始值15.21±1.65mmHg分别降低20%、25%、26%和43%(22小时)。多巴酚丁胺治疗后,心脏指数从2.23±0.6升/分钟/平方米分别增加30%(15分钟)、47%(30分钟)、57%(2小时)和85%(22小时)。肺毛细血管楔压从15.70±3.14mmHg分别降低13%(15分钟)、17%(30分钟)、22%(2小时)和43%(22小时)。依诺昔酮组在最初120分钟内收缩压降低14%,22小时后恢复到初始值。多巴酚丁胺在2小时后使收缩压升高23%,在观察期内维持升高约20%。两组心率均以相似方式略有增加。(摘要截断于250字)