Menichetti A, Chiavarelli R, Tritapepe L, Di Giovanni C, Pacilli M, Cogliati A, Cassese M, Arzilla R
Policlinico Umberto I, Università degli Studi di Roma La Sapienza, Roma.
Minerva Anestesiol. 1997 Jan-Feb;63(1-2):1-8.
Evaluate the effects of enoximone and dopamine in patients with impaired left ventricular function after cardiopulmonary bypass (CPB).
Prospective study on a consecutive series of patients subdivided into two groups: enoximone (Group E) and dopamine (Group D).
Policlinico Umberto I, University La Sapienza of Rome.
Thirty patients undergoing elective myocardial revascularization. Before weaning from CPB the patients received inotropic drugs as follows: Group E: enoximone: bolus: 1 mg/kg in 10 min, and continuous infusion of 5 mcg/kg/min; Gruppo D: dopamine: continuous infusion of 5 mcg/kg/min. Hemodynamic measurements were made using a Swan-Ganz catheter inserted before the induction of anaesthesia.
Enoximone has proved to be effective in decreasing pre-load and after-load of both right and left ventricle by a positive lusitropic effect and a reduction of systolic stress, thereby increasing the cardiac index. In group D patients maintenance of cardiac output has been demonstrated to be dependent on a chronotropic effect. As a consequence in group D the increase in rate-pressure product has reached potentially dangerous values, reflecting a marked increase in myocardial oxygen consumption. On the contrary in Group E the increase in rate-pressure product has been much more limited. Finally both drugs have proven effective, since all patients have been easily weaned from CPB.
Enoximone is a useful and easily-handled drug to facilitate weaning from CPB of patients with preoperative impaired ventricular function.
评估依诺昔酮和多巴胺对体外循环（CPB）后左心室功能受损患者的影响。
对连续系列患者进行的前瞻性研究，分为两组：依诺昔酮组（E组）和多巴胺组（D组）。
罗马第一大学附属翁贝托一世综合医院。
30例接受择期心肌血运重建的患者。在CPB脱机前，患者接受如下强心药物治疗：E组：依诺昔酮：静脉推注：1 mg/kg，10分钟内推注完毕，然后以5 mcg/kg/min持续输注；D组：多巴胺：以5 mcg/kg/min持续输注。使用麻醉诱导前插入的Swan-Ganz导管进行血流动力学测量。
依诺昔酮已被证明可通过正性变松弛作用和降低收缩期应力有效降低右心室和左心室的前负荷和后负荷，从而增加心脏指数。在D组患者中，心输出量的维持依赖于变时作用。因此，D组中率压乘积的增加已达到潜在危险值，反映出心肌氧消耗显著增加。相反，E组中率压乘积的增加则更为有限。最后，两种药物均已证明有效，因为所有患者均已轻松脱离CPB。
依诺昔酮是一种有用且易于使用的药物，有助于术前心室功能受损的患者脱离CPB。
