[Cardiovascular effects of dopamine during neuroleptanaesthesia (author's transl)].
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
S Piepenbrock
Publications and source records attributed to S Piepenbrock.
[The effects of dihydroergotamine on volume content and compliance of the extrathoracic capacitance vessels of man under anesthesia during extracorporeal circulation in hypothermia (author's transl)].
The influence of dihydroergotamine on volume content and compliance of the extrathoracic capacitance vessels during extracorporeal circulation was investigated. Compared with an untreated control group the compliance decreased (0.44 ml/mm Hg/kg b. wt.) and 490 ml of blood was mobilized and shifted from the circulation into the blood reservoir of the machine. Therefore DHE counteracts the effects of venous pooling.
Anesthesia, General↗
[The effects of dihydroergotamine on the circulatory system of man during neurolept analgesia (author's transl)].
The effect of 0.015 mg/kg KHE i.v. on the circulatory system was investigated in 10 patients after closure of an atrial septal defect under neuroleptanalgesia. The arterial pressure increased due to an increase of total systemic resistance. The filling pressures of the right and the left ventricle increased while the stroke index remained unchanged. The maximal rate of rise of left ventricular pressure did not change despite the marked changes of pre- and afterload. The data support the drug mechanism of a volume shift from the peripheral to the central circulation. The possible reasons for the missing stroke index increase are discussed.
Adult↗
[The effects of Akrinor on the extrathoracic capacitance vessels during extracorporeal circulation and on cardiac haemodynamics of anaesthetized man (author's transl)].
The circulatory effects of Akrinor were investigated in anaesthetized patients during extracorporeal circulation and following open heart surgery. Arterial pressure, cardiac index and the maximal rate of rise of left ventricular pressure increased, whereas the resistance to flow in both circuits and the cardiac filling pressures remained unchanged. The compliance of the extrathoracic capacitance vessels during extracorporeal circulation was unaltered compared with the control group, but the volume content was less after Akrinor (200 ml). If this volume is shifted to the intrathoracic compartment in the intact circulation, the amounts seems too small to explain the increase in cardiac index. This increase and the subsequent rise of the arterial pressure seemed to be due to increased myocardial contractility.
Anesthesia↗
Reconstruction of the right ventricular outflow tract including pulmonary valve replacement in 6 children under two years of age.
In 6 children under 2 years of age correction of congenital heart defects required reconstruction of the right ventricular outflow tract including replacement of the pulmonary valve. Outflow tract reconstruction consisted in implantation of a size 14 valved conduit in 2 patients with d-TGA and subpulmonary stenosis and 1-TGA and subpulmonary stenosis, and a size 16 valved conduit in 2 other patients with truncus arteriosus. In 2 children with DOLV, VSD and aneurysm of the pulmonary artery trunk, the pulmonary valve was replaced by porcine heterografts, sizes 19 and 21 respectively, after primary patch reconstruction of the right ventricular outflow tract. There was one operative death in a child with d-TGA, intact ventricular septum and severe subpulmonary stenosis. This child died in low cardiac output, probably because too much contractile muscle was lost at the site of anastomosis with the conduit. For reconstruction of the right ventricular outflow tract, pulmonary valve replacement has proven mandatory in cases with pulmonary hypertension in order to prevent postoperative right heart failure. Similarly, in cases with pulmonary stenosis and hypoplastic pulmonary arteries, postoperative pulmonary insufficiency can be deleterious to the right ventricle.
Aneurysm↗
Hemodynamic effects of dobutamine and epinephrine in patients during coronary surgery.
Explore the source record for details and available documents.
Blood Pressure↗
[Extrarenal effects of potassium-canrenoate. Haemodynamic investigations during neuroleptanalgesia in cardiosurgical patients (author's transl)].
Direct cardiac and vascular effects of the antikaliuretic diuretic potassium-canrenoate were measured in cardio-surgical patients during extracorporal circulation and immediatly after operations, each time in neuroleptanalgesia. During "steady state" extracorporeal circulation (aorta cross-clamped, constant flow rate of heart-lung-machine, constant hypothermia), in 13 patients no significant influence on peripheral circulation was found after i.v.-injection of 800 mg potassium-canrenoate. Neither arterial perfusion pressure (representing an arterial vascular reaction) nor changes in oxygenator-volume (indicating venous vasodilation or contraction) demonstrated significant differences in comparison to a control group. After cardiac surgery haemodynamic measurements were performed for a period of 60 minutes in 10 patients given 800 mg potassium-canrenoate. In comparison with a control group (n = 6), no significant differences in arterial pressure, heart rate, cardiac index and pulmonary arterial pressure were found. Left ventricular measurements, using a catheter tip manometer, revealed no direct positive inotropic effect of a single i.v.-injection of potassium-canrenoate. In acute myocardial failure during anaesthesia or in "low cardiac ouptut" following open heart surgery no improvement in myocardial contractility is obtained by i.v.-application of potassium-canrenoate; at the present there seems no alternative to other positive inotropic agents such as calcium, glucagon, dopamine, orciprenaline and epinephrine.
Adolescent↗
[Haemodynamic and vascular effects of dobutamine during and after open heart operations (author's transl)].
In cardiosurgical patients the haemodynamic effects of dobutamine 2.5 microgram/kg . min and 5 microgram/kg . min dobutamine were investigated during neuroleptanalgesia, intra- and immediately postoperatively. Intraoperative measurements were performed in 8 coronary surgical patients each after sternotomy and pericardiotomy, but before the aortocoronary venous bypass operation. The following haemodynamic parameters increased significantly: cardiac index (2.5 microgram/kg . min: 2.6 leads to 2.1 1/min . m2; 6 microgram/kg . min: 1.5 leads to 2.24 1/min . m2), heart rate (80 leads to 91 min-1; 86 leads to 107 min-1), stroke index (16%, 27%), mean arterial pressure (70 leads to 90 mm Hg; 70 leads to 93 mm Hg), mean pulmonary arterial pressure (8%; 14%), LV dp/dtmax (72%; 121%) and calculated myocardial oxygen consumption Eg (35%; 52%). Changes in right (PRA) and left ventricular filling pressure (PLVED), in total systemic resistance and total pulmonary vascular resistance were not significant. Postoperative measurement immediately after open heart operations (ASD-correction n = 5, aortocoronary venous bypass (n = 3) in neuroleptanalgesia too, showed the same haemodynamic results as intraoperatively before correction of coronary stenosis. Only a few premature ventricular beats were observed in 3 patients and there were no changes in S-T segments during dobutamine infusion. In another group of 15 patients selective vascular responses to an infusion of 10 microgram/kg . min dobutamine were examined during steady state cardiopulmonary bypass excluding heart and lungs from the circulation. No relevant direct influence on the arteriolar resistance vessels and the venous capacitance vessels were found. In a dose range of 2.5--5.0 microgram/kg . min dobutamine proved to be a potent inotropic agent causing almost no peripheral and relatively little positive chronotropic effects. But the increase in heart rate was more pronounced than in other clinical investigations in conscious patients, which might be due to an attenuation of vagal reflex by anaesthesia. The results indicate, that dobutamine may be a valuable drug in the treatment of intra- and postoperative low output syndromes especially in patients with coronary heart disease.
Adult↗
[Comparison of cardiac and vascular effects of sulfentanil (R 30730), a new analgetic, and fentanyl (author's transl)].
In 31 patients with congenital or acquired heart disease, functional class III NYHAC, effects of Sulfentanil (R 30730)--a new analgetic--on hemodynamics, inotropic state and myocardial oxygen consumption have been investigated intraoperatively, during extracorporeal circulation and postoperatively. Results are compared to a fentanyl-group and control-group. There was almost no change in cardiac index and stroke index. In comparison to fentanyl (dose relation fentanyl: sulfentanil = 10:1) there was a more pronounced decrease in aterial pressure, left ventricular pressure, peak dp/dt and myocardial oxygen consumption (-20%) in the sulfentanil-group. In contrast to the fentanyl-group there was, however, no increase in total pulmonary resistance with sulfentanil.
Adult↗
[Cardio-circulatory effects of aminophylline (Euphyllin) (author's transl)].
In 24 patients with congenital or acquired heart disease, functional class II--IV New York Heart Association Classification, effects of aminophylline on hemodynamics have been investigated intraoperatively, during extracorporeal circulation and postoperatively. Aminophylline caused a decrease in arterial pressure, left ventricular pressure, right and left atrial pressure, total systemic resistance and total pulmonary resistance. At the same time there was an increase in heart peak, peak dp/dt, cardiac index and stroke index. Our results demonstrate beneficial cardiac and extracardiac effects of aminophylline in man.
Adult↗
[Diazepam (valium). Changes in haemodynamics, myocardial oxygen consumption and vascular tone (author's transl)].
In 30 patients with congenital or acquired heart disease the haemodynamic effects of diazepam (Valium) 0.3 mg/kg were investigated during surgical procedures under neuroleptanalgesia. The following parameters were measured or calculated: Heart rate (HR), arterial pressure (-Part, Psyst, Pdiast), pulmonary artery pressure (-PAP), right (-PRA) and left atrial pressure (-PLA), left ventricular pressure (PLV), left ventricular enddiastolic pressure (PLVED), left ventricular peak dp/dt (dp/dtmax), cardiac output (CO), cardiac index (CI), stroke volume (SV), stroke index (SI), total systemic resistance (TSR), total pulmonary resistance (TPR), work index of the right (RVWI) and left ventricle (LVWI). In comparison with a control group (n = 36) diazepam caused a decrease in arterial pressure cardiac index, stroke index, right and left atrial pressure and dp/dtmax. This, however, was mainly attributable to vasodilatation and not to a negative inotropic effect, which is of only minor importance with diazepam. These haemodynamic changes resulted in a reduction in myocardial oxygen consumption. Diazepam is a valuable drug in neuroleptanalgesia, when an increase in blood pressure can not be controlled by fentanyl or droperidol.
Blood Pressure↗
[Effects of calcium gluconate and calcium chloride on cardiocirculatory parameters in man (author's transl)].
In 44 patients with congenital or acquired heart disease, functional class II--IV NYHAC, the effects of calcium gluconate (10 ml 10%) and calcium chloride (10 ml 5.5%) on hemodynamics, inotropy and myocardial oxygen consumption were investigated during and immediately after cardiosurgical procedures. There was a significant increase in blood pressure, left ventricular pressure, total systemic resistance, cardiac index, stroke index, peak dp/dt and myocardial oxygen consumption as well as in arterial perfusion pressure during extracorporeal circulation due to i.v.-injection of either one of the drugs. The positive inotropic effects were more pronounced after application of calcium chloride. In emergency situations during anaesthesia or resuscitation, therefore, calcium chloride seems to be of more advantage than calcium gluconate.
Calcium Chloride↗
[The cardiac and vascular effects of furosemide (author's transl)].
Explore the source record for details and available documents.
Adult↗
Massive doses of methylprednisolone (30 mg/kg) in man: immediate haemodynamic effects in "low output state".
Methylprednisolone, 30 mg/kg body weight, was given as an intravenous bolus injection to a total of 31 cardiosurgical patients. Measurements of left ventricular parameters showed no significant increase in dp/dtmax and no significant decrease in left ventricular end-diastolic pressure. There were no important changes in blood pressure, heart rate, cardiac index, stroke index and total peripheral resistance. During 'steady state' extracorporeal circulation no relevant vasodilating effect could be found. In comparison to a control-group there were no important differences in haemodynamic parameters. In cardio-surgical patients, --mainly functional class III--we were unable to demonstrate any gross cardiovascular effects of large doses of methylprednisolone.
Adult↗
Emergency and non-emergency intraatrial correction for transposition of the great arteries in 43 infants. Indications, details of the operative technique and results.
Explore the source record for details and available documents.
Cardiac Catheterization↗
[Intracardiac correction of congenital heart anomalies in 104 infants (author's transl)].
From 1974 to 1976 104 infants (under 1 year of age) underwent intracardiac correction for congenital heart diseases. Mean age and body weight were 6.6 +/- 3.6 months resp. 5.66 +/- 1.4 kgs. The diagnoses and mortality rates were: transposition of the great arteries (TGA) with intact ventricular septum 27 (0), TGA plus associated anomalies 9 (0), ventricular septal defect (VSD) 20 (1), VSD plus associated anomalies 6 (1), total anomalous pulmonary venous drainage 9 (5), pulmonary stenosis and pulmonary atresia with intact ventricular septum 9 (2), aortic stenosis 7 (3), ASD I or II 7 (0), and miscellaneous 10 (3). Intracardiac correction was performed either on cardiopulmonary bypass and moderate hypothermia or in deep hypothermia with or without total circulatory arrest. The early mortality in the first group was 7% (6 out of 90), in the second group 64% (9 out of 14). With increasing experience, cardiopulmonary bypass has proven to be a save method for intracardiac correction of congenital heart anomalies in infancy even in the youngest age group under three months of age and under emergency conditions.
Age Factors↗
[Cardiovascular effects of flunitrazepam (rohypnol, RO-5-4200) (author's transl)].
We reported on the haemodynamic effects of 0.03 mg/kg flunitrazepam during surgical procedures in neuroleptanalgesia in 39 patients with congenital or acquired heart diseases, functional class II-IV. The benzodiazepine derivative did not cause any relevant effect on the inotropic state of the myocardium. There were only minor changes in cardiac index, stroke index, right and left atrial pressure. Changes in arterial pressure and left ventricular pressure during and immediately after surgical procedures, and in arterial perfusion pressure during extracorporeal circulation, as well as an only short lasting increase in heart rate were demonstrative a peripheral vasodilator effect. The decrease in ventricular work and myocardial oxygen consumption are of value in patients with coronary heart disease, especially immediately after surgical procedures. Flunitrazepam is considered an additional drug during neuroleptanalgesia, when hypertension is causing some problems.
Adolescent↗
Changes in hemodynamic parameters, inotropic state, and myocardial oxygen consumption owing to intravenous application of nitroglycerin.
Changes in hemodynamics, inotropic state, and myocardial oxygen consumptom were investigated in a total of 70 patients with coronary disease after intravenous application of nitroglycerin (0.4 mg., 0.2 mg., and 2 mg. per hour). The results demonstrate that nitroglycerin enlarges therapeutic possibilities during and immediately after operations in patients with limited coronary reserve. The decrease in myocardial oxygen consumption, dependent on dose, ranged between 15.8 and 22.9 per cent.
Adult↗