Ruttimann Y, Chioléro R, Revelly J P, Jeanprêtre N, Schutz Y
Department of Anesthesiology, University Hospital, Lausanne, Switzerland.
Crit Care Med. 1994 Aug;22(8):1235-40. doi: 10.1097/00003246-199408000-00006.
The thermogenic effect of amrinone is unknown and its utilization in patients with severe cardiac failure could potentially increase oxygen requirements and therefore aggravate oxygen debt. Consequently, the present study was undertaken to assess the thermogenic response to amrinone at three different plasma concentrations under controlled conditions and to analyze amrinone's effects on various biochemical variables.
A prospective, unblinded, controlled study. The initial control period was followed by three sequential, experimental treatments.
Ten young, healthy, male volunteers with normal body weight.
Three experimental periods. Amrinone was administered intravenously in progressive doses: a) 0.5 mg/kg followed by 5 micrograms/kg/min; b) 0.5 mg/kg followed by 10 micrograms/kg/min; and c) 1.0 mg/kg followed by 10 micrograms/kg/min.
Oxygen consumption (VO2) and CO2 production were continuously measured by means of a computerized indirect calorimeter. At the highest dose, amrinone produced a slight and significant (p < .01) increase in VO2 and in resting metabolic rate (+4.5% and +3.7%, respectively), while no change in CO2 production or in respiratory quotient occurred throughout the study. At the medium and high doses, amrinone increased plasma free fatty acid concentrations by 38% and 53%, respectively (p < .05). No variation in plasma glucose, lactate, insulin, norepinephrine, or epinephrine concentrations was observed during the study.
Amrinone administered intravenously at therapeutic doses has minimal thermogenic and metabolic effects in humans without cardiac failure.
氨力农的产热效应尚不清楚,在严重心力衰竭患者中使用该药可能会增加氧需求,从而加重氧债。因此,本研究旨在评估在可控条件下三种不同血浆浓度的氨力农的产热反应,并分析氨力农对各种生化变量的影响。
一项前瞻性、非盲法、对照研究。初始对照期之后是三个连续的实验性治疗阶段。
10名体重正常的年轻健康男性志愿者。
三个实验阶段。氨力农以递增剂量静脉给药:a)0.5mg/kg,随后以5μg/kg/min给药;b)0.5mg/kg,随后以10μg/kg/min给药;c)1.0mg/kg,随后以10μg/kg/min给药。
通过计算机化间接热量计连续测量耗氧量(VO2)和二氧化碳生成量。在最高剂量时,氨力农使VO2和静息代谢率轻微但显著增加(分别增加4.5%和3.7%,p<.01),而在整个研究过程中二氧化碳生成量或呼吸商没有变化。在中等剂量和高剂量时,氨力农分别使血浆游离脂肪酸浓度增加38%和53%(p<.05)。在研究期间未观察到血浆葡萄糖、乳酸、胰岛素、去甲肾上腺素或肾上腺素浓度的变化。
在无心力衰竭的人体中,以治疗剂量静脉注射氨力农产生的产热和代谢效应极小。