Biomaterial Database

A comparison of the hemodynamic effects of amrinone and sodium nitroprusside in infants after cardiac surgery. 1997

J M Bailey, and B E Miller, and K R Kanter, and S R Tosone, and V K Tam

Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia 30322-1101, USA.

The phosphodiesterase inhibitor amrinone (AMR) increases cardiac output in children after cardiac surgery. In vitro, amrinone has both positive inotropic and vasodilatory effects. However the relative contribution of these effects to the increases in cardiac output observed clinically is unclear, and it has not been demonstrated that amrinone offers a hemodynamic advantage above that of pure vasodilators in infants. We compared the hemodynamic effects of AMR and sodium nitroprusside (SNP) in 10 infants after cardiac surgery. Cardiac index (CI) was measured by thermodilution after SNP administration, titrated to decrease mean blood pressure (MBP) by 20%, and then after a 1.5-mg/kg bolus dose of AMR. Each patient served as his or her own control. Preload, as measured by left atrial pressure and transesophageal echocardiography (in eight patients), was kept constant throughout the protocol. Both SNP and AMR caused significant decreases in MBP and systemic vascular resistance index (SVRI). However, only AMR resulted in a significant increase in CI. The ratio of fractional increase in CI to fractional absolute decrease in MBP was significantly greater for AMR than SNP, indicating greater efficacy for AMR in the treatment of low cardiac output syndrome and suggesting that, in infants after cardiac surgery, AMR has clinically relevant positive inotropic effects.

UI	MeSH Term	Description	Entries
D007223	Infant	A child between 1 and 23 months of age.	Infants
D007231	Infant, Newborn	An infant during the first 28 days after birth.	Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
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
D010726	Phosphodiesterase Inhibitors	Compounds which inhibit or antagonize the biosynthesis or actions of phosphodiesterases.	Phosphodiesterase Antagonists,Phosphodiesterase Inhibitor,Phosphoric Diester Hydrolase Inhibitors,Antiphosphodiesterases,Inhibitor, Phosphodiesterase
D011183	Postoperative Complications	Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.	Complication, Postoperative,Complications, Postoperative,Postoperative Complication
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
D002316	Cardiotonic Agents	Agents that have a strengthening effect on the heart or that can increase cardiac output. They may be CARDIAC GLYCOSIDES; SYMPATHOMIMETICS; or other drugs. They are used after MYOCARDIAL INFARCT; CARDIAC SURGICAL PROCEDURES; in SHOCK; or in congestive heart failure (HEART FAILURE).	Cardiac Stimulant,Cardiac Stimulants,Cardioprotective Agent,Cardioprotective Agents,Cardiotonic,Cardiotonic Agent,Cardiotonic Drug,Inotropic Agents, Positive Cardiac,Myocardial Stimulant,Myocardial Stimulants,Cardiotonic Drugs,Cardiotonics,Agent, Cardioprotective,Agent, Cardiotonic,Drug, Cardiotonic,Stimulant, Cardiac,Stimulant, Myocardial
D006330	Heart Defects, Congenital	Developmental abnormalities involving structures of the heart. These defects are present at birth but may be discovered later in life.	Congenital Heart Disease,Heart Abnormalities,Abnormality, Heart,Congenital Heart Defect,Congenital Heart Defects,Defects, Congenital Heart,Heart Defect, Congenital,Heart, Malformation Of,Congenital Heart Diseases,Defect, Congenital Heart,Disease, Congenital Heart,Heart Abnormality,Heart Disease, Congenital,Malformation Of Heart,Malformation Of Hearts