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[氨力农、多巴酚丁胺和多巴胺对心脏直视手术后心输出量降低综合征的血流动力学影响]

[Hemodynamic effects of amrinone, dobutamine and dopamine in the cardiac low output syndrome following open-heart surgery].

作者信息

Husedzinović I, Rumboldt Z, Ivancan V, Nikić N, Rudeź I, Biocina B, Sutlić Z

机构信息

Zavod za anesteziologiju i intenzivno lijecenje Klinike za kirurgiju KBC Zagreb.

出版信息

Lijec Vjesn. 1995 Jun;117 Suppl 2:32-4.

PMID:8649147
Abstract

Low heart stroke volume syndrome is clinically manifested with hypoperfusion of all body systems. Inotropic or mechanical support is applied. Acute heart failure is one of the most important complications after open heart surgery. Catecholamines have been up to non considered as a therapy of choice for the acute heart failure. Effectiveness of catecholamines could be limited with some side effects. Phosphodiesterase inhibitors promise a new therapeutic approach. PDE III primary act through phosphodiesterase inhibition which leads to a rise of aAPM levels. Thus they show positive inotropic and lusitropic effects, which could be monitored by occlusive pulmonary capillary pressure values. Amrinone is obviously superior to inotropic catecholamines.

摘要

低心排血量综合征临床表现为全身各系统灌注不足。需应用正性肌力药物或机械支持。急性心力衰竭是心脏直视手术后最重要的并发症之一。儿茶酚胺一直未被视为急性心力衰竭的首选治疗药物。儿茶酚胺的有效性可能会受到一些副作用的限制。磷酸二酯酶抑制剂有望成为一种新的治疗方法。磷酸二酯酶Ⅲ主要通过抑制磷酸二酯酶起作用,从而导致心房利钠肽水平升高。因此,它们表现出正性肌力和舒张期心肌松弛作用,这可以通过肺毛细血管闭塞压值进行监测。氨力农明显优于正性肌力儿茶酚胺。

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