Filner B, Karliner J S, Daily P O
Circ Shock. 1977;4(3):223-30.
Of 410 consecutive patients undergoing cardiopulmonary bypass, 13 (3.2%) required pressor and inotropic support beyond volume replacement with whole blood and administration of CaCl2 to discontinue bypass. In 4 patients, isoproterenol was ineffective in maintaining cardiac output and systemic arterial pressure. In 12 patients addition and/or substitution of dopamine permitted discontinuation of cardiopulmonary bypass. In 7 patients who had serial hemodynamic measurements, mean systemic arterial pressure increased by 26%; cardiac index increased by 36%; stroke volume increased by 31%; and stroke work index increased by 83% (all p less than 0.005). There were no significant changes in central venous and mean pulmonary arterial wedge pressures, heart rate, or pulmonary and peripheral vascular resistances. Eleven of the 13 patients survived. We conclude that dopamine is an effective pressor and inotropic agent in the management of left ventricular dysfunction immediately after cardiopulmonary bypass.
在410例连续接受体外循环的患者中，13例（3.2%）在输注全血进行容量替代及给予氯化钙以停止体外循环后，仍需要血管升压药和正性肌力药物支持。4例患者中，异丙肾上腺素无法有效维持心输出量和体动脉压。12例患者加用和/或换用多巴胺后得以停止体外循环。在7例进行了连续血流动力学测量的患者中，平均体动脉压升高了26%；心脏指数升高了36%；每搏量升高了31%；每搏功指数升高了83%（所有p均小于0.005）。中心静脉压、平均肺动脉楔压、心率、肺血管阻力和外周血管阻力均无显著变化。13例患者中有11例存活。我们得出结论，多巴胺是体外循环后即刻处理左心室功能障碍时有效的血管升压药和正性肌力药物。
