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Comparison of the use of a propofol infusion in cardiac surgical patients with normal and low cardiac output states. 1995

K M Sherry, and J Sartain, and J H Bell, and G A Wilkinson
Department of Anesthesia, Northern General Hospital, Sheffield, England.

OBJECTIVE This study compared the hemodynamic effects of a propofol infusion with fentanyl analgesia in patients undergoing cardiac surgery with normal and low cardiac output states. Low cardiac output was defined as a cardiac index less than 2.5 L/min/m2 with a minimum pulmonary capillary wedge pressure of 7 mmHg. METHODS A prospective and open study. METHODS A single center cardiothoracic unit within a teaching hospital. METHODS Patients were assigned to group P, poor cardiac output or group N, normal cardiac output, after thermodilution pulmonary artery catheter assessments. METHODS Both groups received a propofol infusion, 8 mg/kg/hr, until induction of anesthesia, followed by 4 mg/kg/hr until the intensive care unit. Fentanyl, 15 micrograms/kg, and pancuronium, 0.15 mg/kg, were administered after induction. The lungs were ventilated with oxygen. RESULTS Hemodynamic assessments were repeated at intervals until cardiopulmonary bypass. Changes within and between groups were compared using t tests on percentage change from baseline. Group N had significantly greater decreases in cardiac index, stroke volume, and left ventricular stroke work index than group P. There were comparable decreases in mean arterial pressure on induction of anesthesia, 14% and 8% in group N and group P, respectively. In both groups, right ventricular ejection fraction was unchanged. CONCLUSIONS The use of a propofol infusion for induction and maintenance of anesthesia in patients with low cardiac output states undergoing cardiac surgery is not contraindicated.

UI MeSH Term Description Entries
D007262 Infusions, Intravenous The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it. Drip Infusions,Intravenous Drip,Intravenous Infusions,Drip Infusion,Drip, Intravenous,Infusion, Drip,Infusion, Intravenous,Infusions, Drip,Intravenous Infusion
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010197 Pancuronium A bis-quaternary steroid that is a competitive nicotinic antagonist. As a neuromuscular blocking agent it is more potent than CURARE but has less effect on the circulatory system and on histamine release. Pancuronium Bromide,Pancuronium Curamed,Pancuronium Organon,Pavulon,Bromide, Pancuronium
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011669 Pulmonary Wedge Pressure The blood pressure as recorded after wedging a CATHETER in a small PULMONARY ARTERY; believed to reflect the PRESSURE in the pulmonary CAPILLARIES. Pulmonary Artery Wedge Pressure,Pulmonary Capillary Wedge Pressure,Pulmonary Venous Wedge Pressure,Wedge Pressure,Pressure, Pulmonary Wedge,Pressures, Pulmonary Wedge,Pulmonary Wedge Pressures,Wedge Pressure, Pulmonary,Wedge Pressures, Pulmonary,Pressure, Wedge,Pressures, Wedge,Wedge Pressures
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D002302 Cardiac Output The volume of BLOOD passing through the HEART per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with STROKE VOLUME (volume per beat). Cardiac Outputs,Output, Cardiac,Outputs, Cardiac
D002303 Cardiac Output, Low A state of subnormal or depressed cardiac output at rest or during stress. It is a characteristic of CARDIOVASCULAR DISEASES, including congenital, valvular, rheumatic, hypertensive, coronary, and cardiomyopathic. The serious form of low cardiac output is characterized by marked reduction in STROKE VOLUME, and systemic vasoconstriction resulting in cold, pale, and sometimes cyanotic extremities. Low Cardiac Output,Low Cardiac Output Syndrome,Output, Low Cardiac
D002315 Cardiopulmonary Bypass Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs. Heart-Lung Bypass,Bypass, Cardiopulmonary,Bypass, Heart-Lung,Bypasses, Cardiopulmonary,Bypasses, Heart-Lung,Cardiopulmonary Bypasses,Heart Lung Bypass,Heart-Lung Bypasses

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