Haemodynamic effects of ethanol immediately after aortic valve replacement. A clinical study peroperatively and in the early postoperative period.

The haemodynamic effects of intravenous (i.v.) administration of ethanol were studied in two groups of patients--groups IV and V--during the first hours after aortic valve replacement. A group of seven patients, who underwent the same operation but were not treated with ethanol, served as controls (Klingen et al., 1978 c). The ethanol was given by continuous i.v. infusion. It was started after termination of bypass and was continued for 6 hours postoperatively. Group IV (9 patients) had a blood concentration of about 20 mmol/l. Group V (8 patients) had a blood concentration constant at 35-40 mmol/l. Groups IV and V differed from group III in their reactions in the following respects, and the differences may be attributed to the ethanol. In the former groups the arterial (systemic) blood pressure and total peripheral vascular resistance were lower (P less than 0.01 and P less than 0.001, respectively). Cardiac output was higher (P less than 0.05) and the arteriovenous oxygen difference lower (P less than 0.01) in group IV and V and increased at an early stage (P less than 0.01). The study shows that ethanol in blood concentrations of 20 and 35-40 mmol/l has approximately the same vasodilative effect, with no influence on the heart rate and no depressive effect on myocardial function; on the contrary this function tended to be stimulated at a blood concentration of 35-40 mmol/l.