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In 12 patients with moderate low-output-syndrome following aortocoronary bypass grafting, the pump function of the left ventricle was improved by sodium nitroprusside (SNP) and dopamine. The cardiac index (CI) on termination of cardio-pulmonary bypass was 2.2 +/- 0.2 1/min.m2 and the pulmonary capillary wedge pressure (PCWP) 20 +/- 3 mm Hg. Folowing infusion of SNP the Cl reached 2.4 +/- 0.2 l/min.m2 (p less than 0.05) and the PCWP was reduced to 13 +/- 3 mm Hg (p less than 0.01). After transfusion of blood the PCWP increased to 18 +/- 2 mm Hg (p less than 0.01), and the CI increased to 2.8 +/- 0.2 l/min.m2 (p less than 0.05). After administration of dopamine the CI was further improved to 3.3 l/min.m2, the PCWP remained constant. The combined therapy with dopamine and SNP is a rational concept to improve the function of the heart in failure following open heart surgery.
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