Prielipp R C, Butterworth J F, Zaloga G P, Robertie P G, Royster R L
Department of Anesthesia, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27103.
Chest. 1991 Apr;99(4):820-5. doi: 10.1378/chest.99.4.820.
The hemodynamic and oxygen transport effects of low-dose (0.75 mg/kg loading dose + 10 micrograms/kg/min infusion, n = 12) and high-dose (2.25 mg/kg loading dose + 20 micrograms/kg/min infusion, n = 12) amrinone were evaluated in extubated patients 24 h after CABG. At both doses, amrinone significantly (p less than 0.05) increased HR, but decreased mean arterial, mean pulmonary artery, central venous and pulmonary artery occlusion pressures. High-dose amrinone significantly decreased systemic vascular resistance. Arterial oxygen saturation decreased significantly following both low- (97.8 +/- 0.4 to 95.6 +/- 0.9 percent) and high- (98.8 +/- 3.4 to 93.9 +/- 1.2 percent) dose amrinone. Pulmonary shunt increased significantly following low-dose amrinone and markedly increased Qs/Qt after high-dose amrinone. Although amrinone significantly increased cardiac index in a dose-dependent fashion (low:3.0 +/- 0.2 to 3.3 +/- 0.3 L/min/m2; high:2.7 +/- 0.2 to 3.4 +/- 0.2 L/min/m2), mixed venous oxygen saturation did not change. Thus, mixed venous oxygen saturation may not predict the hemodynamic response to amrinone infusion in postoperative surgical patients.
在冠状动脉旁路移植术（CABG）后24小时的拔管患者中，评估了低剂量（负荷剂量0.75mg/kg + 输注速度10μg/kg/min，n = 12）和高剂量（负荷剂量2.25mg/kg + 输注速度20μg/kg/min，n = 12）氨力农对血流动力学和氧输送的影响。在这两种剂量下，氨力农均显著（p<0.05）增加心率，但降低平均动脉压、平均肺动脉压、中心静脉压和肺动脉闭塞压。高剂量氨力农显著降低全身血管阻力。低剂量（从97.8±0.4%降至95.6±0.9%）和高剂量（从98.8±3.4%降至93.9±1.2%）氨力农后动脉血氧饱和度均显著下降。低剂量氨力农后肺分流显著增加，高剂量氨力农后Qs/Qt明显增加。虽然氨力农以剂量依赖方式显著增加心脏指数（低剂量：从3.0±0.2升至3.3±0.3L/min/m²；高剂量：从2.7±0.2升至3.4±0.2L/min/m²），但混合静脉血氧饱和度未改变。因此，混合静脉血氧饱和度可能无法预测术后外科患者对氨力农输注的血流动力学反应。
