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The Annals of Thoracic Surgery, Vol 27, 523-528, Copyright © 1979 by The Society of Thoracic Surgeons
G Benzing 3d, JA Helmsworth, JT Schreiber and S Kaplan
We evaluated the acute hemodynamic effects of treatment of the low output
state with sodium nitroprusside and epinephrine in 13 children after
intracardiac operation. The 13 patients were selected from a consecutive
series of 106 children undergoing cardiopulmonary bypass. They had a
cardiac index less than 2.0 L/min/m2, even after an increase in left
ventricular filling pressure and during infusion of nitroprusside. Although
the nitroprusside brought about a significant increase in cardiac output
and decrease in systemic vascular resistance, the cardiac index remained
critically low (less than 2 L/min/m2). Epinephrine resulted in a further
significant increase in the cardiac index, without a significant change in
systemic resistance. This study suggests that in selected patients the
simultaneous use of both a vasodilator drug (sodium nitroprusside) and a
positive inotropic agent (epinephrine) is advantageous in the short-term
treatment of the low cardiac output state after intracardiac operation.
ARTICLES
Nitroprusside and epinephrine for treatment of low output in children after open-heart surgery
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