Sarnowski W, Ponizyński A, Lowicki Z, Dyszkiewicz W, Paluszkiewicz L
Kliniki Kardio-Torakochirurgii, Poznaniu.
Pol Tyg Lek. 1994;49(25-26):564-5, 569.
In many patients operated on for valvular heart diseases indications are present to digitalis administration in the preoperative period. During extracorporeal circulation fluctuations occur of blood potassium concentration which increase the risk for toxic effect of digitalis. In the work, digoxin concentration was studied in the serum of patients operated on in extracorporeal circulation in whom administration of this drug was discontinued 48 hours before the operation. The first digoxin dose (0.5 mg) was given directly after withdrawal of extracorporeal circulation, and another 0.5 mg was given after 4 hours. Digoxin concentrations were determined by fluorescence-polarization-immunological method using TD* Abbott device. The digoxin concentration increased rapidly and reached its peak after 6 hours (1.9 ng/ml), decreasing after 12 hours to 0.9 ng/ml and persisted at this therapeutic level in further samples. The present studies demonstrated that digoxin administration directly after withdrawal of extracorporeal circulation and within 24 hours after the operation in commonly accepted doses provided therapeutic concentration of the drug and caused no increase of the risk for toxic reaction development.
在许多接受心脏瓣膜病手术的患者中，术前有使用洋地黄的指征。体外循环期间，血钾浓度会出现波动，这增加了洋地黄中毒的风险。在这项研究中，对在体外循环下接受手术且术前48小时停用该药的患者血清中的地高辛浓度进行了研究。第一剂地高辛（0.5毫克）在体外循环撤除后立即给予，4小时后再给予0.5毫克。使用雅培TD*设备通过荧光偏振免疫法测定地高辛浓度。地高辛浓度迅速升高，6小时后达到峰值（1.9纳克/毫升），12小时后降至0.9纳克/毫升，并在后续样本中维持在该治疗水平。目前的研究表明，体外循环撤除后立即及术后24小时内以常用剂量给予地高辛可使药物达到治疗浓度，且不会增加发生毒性反应的风险。
