Zwölfer W, Dressler H T, Keznickl P, Dieterich H A
Department of Cardiothoracic Anesthesia and Intensive Care, University of Vienna, Austraia.
Clin Cardiol. 1995 Mar;18(3):145-9. doi: 10.1002/clc.4960180308.
This prospective, randomized, comparative study was designed to assess the inotropic and vasodilatory effects of the selective phosphosidesterase III inhibitor enoximone compared with standard therapy with epinephrine/nitroglycerin in patients with refractory low output states following cardiac valve replacement. Enoximone possesses inotropic and vasodilatory properties and has proven to be of beneficial effect in patients suffering from severely impaired myocardial function. Six patients in each group received either enoximone bolus-infusion of 0.5 mg/kg over 10 min followed by an infusion of 5 micrograms/kg/min up to 20 micrograms/kg/min or epinephrine and nitroglycerin infusion of 0.05 and 0.5 micrograms/kg/min, respectively, for 4 hours postoperatively. Hemodynamic effects of enoximone and the combination of epinephrine/nitroglycerin were compared. Both treatments led to positive inotropy with a simultaneous decrease in filling pressures and vascular resistances. The results indicate that enoximone in low-output states following cardiac valve replacement was at least equally effective in comparison with standard therapy with epinephrine and nitroglycerin.
这项前瞻性、随机、对照研究旨在评估选择性磷酸二酯酶III抑制剂依诺昔酮与肾上腺素/硝酸甘油标准疗法相比，对心脏瓣膜置换术后难治性低心排血量状态患者的变力性和血管舒张作用。依诺昔酮具有变力性和血管舒张特性，已被证明对心肌功能严重受损的患者有益。每组6例患者，一组在10分钟内静脉推注依诺昔酮0.5mg/kg，随后以5μg/kg/min的速度持续输注，最高可达20μg/kg/min；另一组在术后4小时分别以0.05和0.5μg/kg/min的速度静脉输注肾上腺素和硝酸甘油。比较了依诺昔酮与肾上腺素/硝酸甘油联合应用的血流动力学效应。两种治疗均导致正性肌力作用，同时充盈压和血管阻力降低。结果表明，在心脏瓣膜置换术后低心排血量状态下，依诺昔酮与肾上腺素和硝酸甘油标准疗法相比至少同样有效。
