Holt A W
Department of Anaesthesia and Intensive Care, Flinders Medical Centre, Adelaide, Australia.
Crit Care Med. 1989 Dec;17(12):1270-6. doi: 10.1097/00003246-198912000-00006.
The hemodynamic response after an iv loading dose of amiodarone for resistant supraventricular tachyarrhythmias was studied in ten critically ill patients receiving a catecholamine infusion for shock. A loading dose of amiodarone, 3.7 to 5.0 mg/kg, was infused over 2 h while the catecholamine infusion dose requirements were monitored. There was a significant decrease in heart rate (mean 16%, p less than .01), and an increase in stroke volume index (mean 29%, p less than .01) and left ventricular stroke work index (mean 34%, p less than .01). Cardiac index, oxygen availability index, and mean arterial pressure were not changed significantly. The reported adrenoreceptor antagonism of amiodarone did not change catecholamine dose requirements in this study. In nine of ten patients, sinus rhythm was achieved and maintained. The loading dose of amiodarone had no significant acute effect on plasma digoxin concentrations. Despite good arrhythmia control, mortality was high.
在十名因休克而接受儿茶酚胺输注的重症患者中，研究了静脉注射负荷剂量胺碘酮治疗顽固性室上性快速心律失常后的血流动力学反应。负荷剂量的胺碘酮，3.7至5.0mg/kg，在2小时内输注，同时监测儿茶酚胺输注剂量需求。心率显著降低（平均16%，p<0.01），每搏量指数增加（平均29%，p<0.01），左心室每搏功指数增加（平均34%，p<0.01）。心脏指数、氧供指数和平均动脉压无显著变化。本研究中，胺碘酮报道的肾上腺素能受体拮抗作用未改变儿茶酚胺剂量需求。十名患者中有九名实现并维持了窦性心律。胺碘酮的负荷剂量对血浆地高辛浓度无显著急性影响。尽管心律失常控制良好，但死亡率很高。
