Brinkmann H M, Krier C, Fleischer F, Dressler P, Späth J
Anasth Intensivther Notfallmed. 1982 Feb;17(1):15-20.
The haemodynamic effect of combined intravenous administration of 18 mg/h dihydralazine and 0.6 mg/h nitroglycerine was examined in the intraoperative and postoperative phases of cardiac surgery (replacement of the aortic and mitral valve or of both valves, and aortocoronary bypass surgery(. Indication for therapy was supplied by a preoperative cardiac index below 2.8 l/min . m2 and an enhanced peripheral resistance above 1200 dyne . sec . cm-5. During a 19-hour observation period the haemodynamic parameters such as cardiac index (+36%) and stroke index (+19%) increased significantly within the investigated group, whereas the peripheral vascular resistance dropped by 16% and the left atrial pressure by 20%. Arterial mean pressure and heart rate did not change. In a patient group treated exclusively with nitroglycerin, the cardiac index decreased (-8%), while the peripheral vascular resistance increased (+6%); an untreated control group showed an increase of the cardiac index by 5%, whereas there was no appreciable change in peripheral vascular resistance and stroke index. The combined use of dihydralazine and nitroglycerin during the perioperative phase of cardiac surgery appears recommendable, since it is possible by such administration to monitor cardiac preload and afterload due to selectivity of the pharmacological sites of action.
在心脏手术（主动脉瓣和二尖瓣置换术或双瓣置换术以及主动脉冠状动脉搭桥手术）的术中及术后阶段，研究了静脉联合输注18毫克/小时的肼屈嗪和0.6毫克/小时的硝酸甘油的血流动力学效应。治疗指征为术前心脏指数低于2.8升/分钟·平方米且外周阻力增强超过1200达因·秒·厘米⁻⁵。在19小时的观察期内，研究组的血流动力学参数如心脏指数（增加36%）和每搏指数（增加19%）显著增加，而外周血管阻力下降16%，左心房压力下降20%。动脉平均压和心率未改变。在仅用硝酸甘油治疗的患者组中，心脏指数下降（-8%），而外周血管阻力增加（+6%）；未治疗的对照组心脏指数增加5%，而外周血管阻力和每搏指数无明显变化。在心脏手术围手术期联合使用肼屈嗪和硝酸甘油似乎是可取的，因为通过这种给药方式，由于药理作用部位的选择性，可以监测心脏前负荷和后负荷。
