Vasoconstriction with phenylephrine increases cardiac output in preload dependent patients.
Lithium dilution cardiac output
Phenylephrine
Preload dependency
Vasopressor
Vasopressor preload modulation
Journal
Journal of clinical monitoring and computing
ISSN: 1573-2614
Titre abrégé: J Clin Monit Comput
Pays: Netherlands
ID NLM: 9806357
Informations de publication
Date de publication:
21 Jun 2024
21 Jun 2024
Historique:
received:
16
04
2024
accepted:
02
06
2024
medline:
22
6
2024
pubmed:
22
6
2024
entrez:
21
6
2024
Statut:
aheadofprint
Résumé
General Anaesthesia (GA) is accompanied by a marked decrease in sympathetic outflow and thus loss of vasomotor control of cardiac preload. The use of vasoconstriction during GA has mainly focused on maintaining blood pressure. Phenylephrine (PE) is a pure α1-agonist without inotropic effects widely used to correct intraoperative hypotension. The potential of PE for augmenting cardiac stroke volume (SV) and -output (CO) by venous recruitment is controversial and no human studies have explored the effects of PE in preload dependent circulation using indicator dilution technique. We hypothesized that PE-infusion in patients with cardiac stroke volume limited by reduced preload would restore preload and thus augment SV and CO. 20 patients undergoing GA for gastrointestinal surgery were monitored with arterial catheter and LiDCO unity monitor. Upon stable haemodynamics after induction patients were placed in head-up tilt (HUT). All patients became preload responsive as verified by a stroke volume variation (SVV) of > 12%. PE-infusion was then started at 15-20mikrg/min and adjusted until preload was restored (SVV < 12%). Li-dilution cardiac output (CO) was initially measured after induction (baseline), again with HUT in the preload responsive phase, and finally when preload was restored with infusion of PE.At baseline SVV was 10 ± 3% (mean ± st.dev.), CI was 2,6 ± 0,4 L/min*m
Identifiants
pubmed: 38907106
doi: 10.1007/s10877-024-01186-7
pii: 10.1007/s10877-024-01186-7
doi:
Banques de données
ClinicalTrials.gov
['NCT05193097']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s).
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