Comparison of Enoximone With Dopamine Following Mitral Valve Surgery.

Tarr, T.J.; Jeffrey, Robert R.; Cowen, M. E.; Kent, A.P.

doi:10.1213/00000539-199002001-00403

Cited by 5 publications

(11 citation statements)

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“…Since the Primacorp study, we know that preventive infusion of phosphodiesterase III inhibitor significantly reduces the incidence of postoperative low cardiac output state 13 . In both our experience and the literature, enoximone is the most potent product in this therapeutic class 14,15 and probably the best way to avoid or limit postoperative cardiac insufficiency.…”

Section: Commentsmentioning

confidence: 76%

Prolonged warm ischemia for transfusion-free arterial switch and ventricular septal defect surgery in a 4.5-Kg baby

Rubatti

Durandy

2012

Perfusion

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Blood-free pediatric surgery is increasingly used for surgical correction of simple cardiopathies. Herein, we describe a complex cardiopathy, arterial switch operation and ventricular septal defect, with pre-operative thrombocytopenia in a 4.5 Kg baby treated with warm surgery and intermittent warm blood microplegia without any blood product. Bypass time was 89 min and aortic cross-clamp time 61 min. The maximal length of warm ischemia (time between microplegia injections) was 42 minutes. The postoperative course was uneventful. The patient was weaned off the ventilator after 7 hours, was discharged from the ICU on day 2 and was discharged from the hospital on day 7. The two main factors involved in this result were high pre-operative hemoglobin level and bypass technique with small prime volume, microplegia and warm perfusion. However, the success of this challenging case is also the result of teamwork and of rigorous patient care.

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Section: Commentsmentioning

confidence: 76%

Prolonged warm ischemia for transfusion-free arterial switch and ventricular septal defect surgery in a 4.5-Kg baby

Rubatti

Durandy

2012

Perfusion

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“…Tarr and coworkers [18] compared the efficacies of dopamine, dobutamine and enoximone for weaning from CPB in a randomized trial of 75 patients. Nine of the 25 patients randomly assigned to dopamine failed to respond adequately, and the remaining 16 recorded an increase in CI of 25.7% but this was accompanied by an increase in HR of 44.3%, with little change in SVI.…”

Section: Resultsmentioning

confidence: 99%

“…In the study conducted by Ensinger and coworkers [31], in which they compared dobutamine at 6.0 μg/kg per min with placebo, a significant increase in CI of 46% was recorded. Studies by Feneck and coworkers [2] and Tarr and colleagues [18], investigating the haemodynamic effects of dobutamine in LCOS, identified increases in HR in excess of 25%. Significant reductions in SVR (> 40% in the study by Tarr and coworkers) were also recorded.…”

Section: Resultsmentioning

confidence: 99%

“…The randomized trial of 75 patients conducted by Tarr and coworkers in 1993 [18] identified no statistically significant difference in CI between enoximone and dobutamine (both drugs effectively increased CI). However, dobutamine produced significantly more tachycardia, and enoximone produced significantly greater increases in SVI.…”

Section: Resultsmentioning

confidence: 99%

“…One small, prospective, randomized trial failed to show any significant haemodynamic differences between amrinone and enoximone [62]. In the prospective, randomized, blinded trial conducted by Tarr and coworkers in 75 patients [18], only in the enoximone group were all patients successfully weaned from CPB, whereas three patients from the dobutamine group and nine from the dopamine group were withdrawn from the study because of inadequate response. The enoximone group exhibited a significantly lesser increase in HR and a greater increase in stroke index than did either the dopamine or dobutamine group, and also exhibited significantly a greater increase in CI and decrease in SVR in comparison with dopamine.…”

Section: Resultsmentioning

confidence: 99%

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et al. 2005

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266 CABG = coronary artery bypass grafting; CI = cardiac index; CPB = cardiopulmonary bypass; HR = heart rate; ICG = indocyanine green; ICU = intensive care unit; IMA = internal mammary artery; LCOS = low cardiac output syndrome; LVEF = left ventricular ejection fraction; MAP = mean arterial pressure; NO = nitric oxide; PDI = phosphodiesterase inhibitor; pHi = intramucosal pH; PVR = pulmonary vascular resistance; SVR = systemic vascular resistance; SVI = stroke volume index. Critical Care June 2005 Vol 9 No 3 Gillies et al. AbstractMany adult patients require temporary inotropic support after cardiac surgery. We reviewed the literature systematically to establish, present and classify the evidence regarding choice of inotropic drugs. The available evidence, while limited in quality and scope, supports the following observations; although all β-agonists can increase cardiac output, the best studied β-agonist and the one with the most favourable side-effect profile appears to be dobutamine. Dobutamine and phosphodiesterase inhibitors (PDIs) are efficacious inotropic drugs for management of the low cardiac output syndrome. Dobutamine is associated with a greater incidence of tachycardia and tachyarrhythmias, whereas PDIs often require the administration of vasoconstrictors. Other catecholamines have no clear advantages over dobutamine. PDIs increase the likelihood of successful weaning from cardiopulmonary bypass as compared with placebo. There is insufficient evidence that inotropic drugs should be selected for their effects on regional perfusion. PDIs also increase flow through arterial grafts, reduce mean pulmonary artery pressure and improve right heart performance in pulmonary hypertension. Insufficient data exist to allow selection of a specific inotropic agent in preference over another in adult cardiac surgery patients. Multicentre randomized controlled trials focusing on clinical rather than physiological outcomes are needed.

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Einfluss der Kardioanästhesie auf das Patientenoutcome

Nowak-Machen¹

2017

Anästhesiol Intensivmed Notfallmed Schmerzther

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The perioperative management of complex patients in a highly technical and subspecialized environment is the domain of the cardiac anesthesiologist. Evidence suggests that hemodynamic management using goal directed hemodynamic therapy (GDHT) improves patient outcome. Organ protection remains a main concern during cardiac surgery using extracorporeal circulation. Mortality can be decreased when remote ischemic preconditioning techniques (RIPC) are being used. Neurological outcomes can be improved with near-infrared-spectometry (NIRS), volatile anesthetics increase myocardial protection through preconditioning and perioperative echocardiography increases overall patient survival.

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Comparison of Enoximone With Dopamine Following Mitral Valve Surgery.

Cited by 5 publications

References 0 publications

Prolonged warm ischemia for transfusion-free arterial switch and ventricular septal defect surgery in a 4.5-Kg baby

Prolonged warm ischemia for transfusion-free arterial switch and ventricular septal defect surgery in a 4.5-Kg baby

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Einfluss der Kardioanästhesie auf das Patientenoutcome

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