Hemodynamic Advantages of Left Atrial Epinephrine Administration in Open Heart Operations

Aral, Atilla; Oğuz, Mehmet; Özberrak, Haldun; Batislam, Yeşim; Çorapçıoğlu, Tümer; Eren, Neyyir Tuncay; Taşöz, Refik; Akalin, Hakkı

doi:10.1016/s0003-4975(97)00798-4

Cited by 5 publications

(2 citation statements)

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“…Lower concentrations of the inotropic agent reach the heart and systemic circulation because the venous route could have the disequilibrium dilution effect and pulmonary elimination 11). Additionally, venous administration of epinephrine may trigger pulmonary vasoconstriction, resulting in increased pulmonary arterial pressure and pulmonary vascular resistance 12). Aral et al12) evaluated the hemodynamic advantages of left atrial epinephrine administration during open heart operation.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, venous administration of epinephrine may trigger pulmonary vasoconstriction, resulting in increased pulmonary arterial pressure and pulmonary vascular resistance 12). Aral et al12) evaluated the hemodynamic advantages of left atrial epinephrine administration during open heart operation. They showed that the average pulmonary arterial pressure and pulmonary vascular resistance were higher in the central venous group, whereas higher cardiac indices and average BP were noted in the left atrial group.…”

Section: Discussionmentioning

confidence: 99%

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Usefulness of Intracoronary Epinephrine in Severe Hypotension during Percutaneous Coronary Interventions

et al. 2013

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Background and ObjectivesLife-threatening hypotension during percutaneous coronary interventions (PCI) is devastating for the patient and is associated with fatal adverse outcomes. The aim of our study was to assess the usefulness of intracoronary epinephrine in severe hypotension unresponsive to other measures during PCI.Subjects and MethodsWe analyzed the Pusan National University Yangsan hospital cardiac catheterization laboratory database to identify patients who underwent PCI from December 2008 to July 2012. The outcomes were changes of blood pressure (BP) and heart rate (HR) before and after intracoronary epinephrine and in-hospital mortality.ResultsA total of 30 patients who were initially stable and received intracoronary epinephrine for severe hypotension during PCI were included. Following administration of intracoronary epinephrine (dose 181±24.8 microgram), systolic and diastolic BP (from 53.8±13.0 mm Hg up to 112.8±21.2 mm Hg, from 35±7.6 mm Hg up to 70.6±12.7 mm Hg, respectively) and HR (from 39.4±5.1 beats/min up to 96.8±29.3 beats/min) were increased. Additionally, 21 patients (70%) showed hemodynamically acceptable responses to intracoronary epinephrine without the intraaortic balloon pump and temporary pacemaker during the PCI. In-hospital mortality was 17% (n=5).ConclusionAlthough our study was small, intracoronary epinephrine was found to be well tolerated and resulted in prompt and successful recovery from severe hypotension in most patients when other measures were ineffective. Intracoronary epinephrine could be a safe and useful measure in patients developing severe hypotension during PCI.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%