Keogh B, Priddy R, Morgan C, Gillbe C
Department of Anaesthesia and Intensive Care, Brompton Hospital, London, UK.
Cardiology. 1990;77 Suppl 3:58-61; discussion 62-7. doi: 10.1159/000174673.
In the light of several incidences at Brompton Hospital in which enoximone brought about a striking improvement in cardiac index in patients with refractory left ventricular failure, a study was initiated to compare the effects of enoximone and dobutamine following cardiopulmonary bypass in patients with impaired left ventricular function (preoperative ejection fraction less than 0.5). In two groups of 10 patients, similar responses of haemodynamic variables were obtained with enoximone or dobutamine administration. In particular, mean cardiac index increased by 25% in the first 15 min and by 60% over the 24-hour study period after bypass. Mean systemic vascular resistance fell by approximately 10%. Mixed venous oxygen saturation increased marginally from a preoperative value of approximately 76% within 15 min of drug administration and then fell and stabilized at about 65% in the next 12 h during re-warming. Patients were weaned from enoximone, after 24 h, without event. Both drugs were shown to produce favourable haemodynamic profiles and to be well tolerated in this relatively high-risk cohort of patients.
鉴于在布朗普顿医院发生的几起事件，依诺昔酮使难治性左心室衰竭患者的心指数显著改善，因此开展了一项研究，比较依诺昔酮和多巴酚丁胺对左心室功能受损（术前射血分数小于0.5）患者体外循环后的影响。在两组各10例患者中，给予依诺昔酮或多巴酚丁胺后，血流动力学变量的反应相似。特别是，平均心指数在最初15分钟内增加了25%，在体外循环后的24小时研究期间增加了60%。平均体循环血管阻力下降了约10%。混合静脉血氧饱和度在给药后15分钟内从术前约76%的水平略有上升，然后在复温后的接下来12小时内下降并稳定在约65%。24小时后，患者停用依诺昔酮，未发生不良事件。在这个相对高危的患者队列中，两种药物均显示出良好的血流动力学特征且耐受性良好。
