Department of Pediatric Cardiology, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Pediatr Crit Care Med. 2010 Sep;11(5):589-92. doi: 10.1097/PCC.0b013e3181ceae7d.
To characterize the effects of dexmedetomidine on the pulmonary artery pressure in patients after congenital cardiac surgery.
Prospective observational pilot study.
Pediatric cardiac intensive care unit at a university hospital.
Twenty-two patients who received dexmedetomidine after cardiothoracic surgery.
None.
An echocardiogram was performed at three time points: 1) baseline (T0); 2) 6 mins after dexmedetomidine loading (T1); and 3) 1 hr after initiation of dexmedetomidine infusion (T2). Transthoracic echocardiography was used to estimate pulmonary artery pressure based on tricuspid regurgitant velocity (4 x Velocity2) plus central venous pressure. Twenty-two patients aged 0.9 yrs old (interquartile range, 7.9) were enrolled at a median of 1 hr (1.5) after surgery. Dexmedetomidine loading, 0.62 microg/kg (0.5), was given in all patients followed by 0.5 microg/kg/hr (0.6) at T1 and 0.65 microg/kg/hr (0.5) at T2. None of the patients had any increase in pulmonary artery pressure. Overall, the pulmonary artery pressure decreased from 30 mm Hg (13) at T0 to 24 mm Hg (10) at T1 and 26 mm Hg (8) at T2 (p < .001). The pulmonary artery pressure/systemic systolic blood pressure ratio decreased from 33% (12) at T0 to 23% (15) at T1 and 25% (13) at T2 (p = .002). There was no difference in the left ventricular function, Fio2, oxygen %, Po2, CO2, and vasoactive agents.
Administration of dexmedetomidine after congenital cardiac surgery was not associated with any increase in pulmonary artery pressure.
描述右美托咪定对先天性心脏病手术后患者肺动脉压的影响。
前瞻性观察性初步研究。
大学医院儿科心脏重症监护病房。
22 例心胸手术后接受右美托咪定治疗的患者。
无。
在三个时间点进行了超声心动图检查：1）基线（T0）；2）右美托咪定负荷后 6 分钟（T1）；3）右美托咪定输注开始后 1 小时（T2）。经胸超声心动图根据三尖瓣反流速度（4×Velocity2）加中心静脉压来估计肺动脉压。22 例年龄为 0.9 岁（四分位距，7.9）的患者在手术后中位数 1 小时（1.5）时入组。所有患者均给予右美托咪定负荷量 0.62μg/kg（0.5），然后在 T1 时给予 0.5μg/kg/hr（0.6），在 T2 时给予 0.65μg/kg/hr（0.5）。没有患者的肺动脉压增加。总体而言，肺动脉压从 T0 时的 30mmHg（13）下降至 T1 时的 24mmHg（10）和 T2 时的 26mmHg（8）（p<.001）。肺动脉压/全身收缩压比值从 T0 时的 33%（12）下降至 T1 时的 23%（15）和 T2 时的 25%（13）（p=0.002）。左心室功能、FiO2、氧%、Po2、CO2 和血管活性药物均无差异。
先天性心脏病手术后给予右美托咪定不会导致肺动脉压升高。
