A comparison of fenoldopam and nitroprusside in the control of hypertension following coronary artery surgery. 1993

A J Hill, and R O Feneck, and R K Walesby
Department of Anesthesia, London Chest Hospital, England.

A prospective trial to compare the effects of the synthetic dopaminergic (DA1) agonist, fenoldopam (FEN), with sodium nitroprusside (SNP) for control of blood pressure following coronary artery bypass graft surgery was carried out in 20 patients. Patients were randomly allocated to receive either FEN or SNP when the systolic arterial blood pressure (SAP) rose above 130 mmHg. The goal of therapy was to achieve a stable control of blood pressure below 130 mmHg at a level at least 25 mmHg below the pretreatment value. Treatment was then continued for 2 hours. Hemodynamic measurements were made before treatment, after stable control of blood pressure had been achieved, and thereafter at 30, 60, and 120 minutes. Urine output, sodium, potassium, and creatinine clearance were also measured during the study. Both SNP and FEN caused a rapid and significant fall in SAP (P < 0.001) and a fall in systemic vascular resistance (P < 0.001). FEN caused an increase in cardiac index (P < 0.001) and in stroke volume (P < 0.001) in contrast to SNP. Urine output and potassium clearance fell with SNP (P < 0.05) in contrast to FEN. Thus, FEN would appear to control SAP as effectively as SNP, but may have more beneficial effects on cardiac output and some aspects of renal function.

UI MeSH Term Description Entries
D006973 Hypertension Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more. Blood Pressure, High,Blood Pressures, High,High Blood Pressure,High Blood Pressures
D007668 Kidney Body organ that filters blood for the secretion of URINE and that regulates ion concentrations. Kidneys
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009599 Nitroprusside A powerful vasodilator used in emergencies to lower blood pressure or to improve cardiac function. It is also an indicator for free sulfhydryl groups in proteins. Nitroferricyanide,Sodium Nitroprusside,Cyanonitrosylferrate,Ketostix,Naniprus,Nipride,Nipruton,Nitriate,Nitropress,Nitroprussiat Fides,Nitroprusside, Disodium Salt,Nitroprusside, Disodium Salt, Dihydrate,Disodium Salt Nitroprusside,Nitroprusside, Sodium
D011188 Potassium An element in the alkali group of metals with an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte that plays a significant role in the regulation of fluid volume and maintenance of the WATER-ELECTROLYTE BALANCE.
D011651 Pulmonary Artery The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. Arteries, Pulmonary,Artery, Pulmonary,Pulmonary Arteries
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

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