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Effects of phentolamine on tissue perfusion in pediatric cardiac surgery

O Köner1, S Tekin, A Köner

  • 1Department of Anaesthesiology and Intensive Care, Cardiology Institute of Istanbul University, Turkey.

Journal of Cardiothoracic and Vascular Anesthesia
|May 7, 1999
PubMed

Insights

Phentolamine administration during cardiopulmonary bypass (CPB) in pediatric heart surgery reduced lactate levels and improved body perfusion. This suggests phentolamine can mitigate CPB

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Pharmacology

Background:

  • Cardiopulmonary bypass (CPB) can cause adverse effects in pediatric patients with congenital heart disease.
  • Pharmacologic vasodilation may offer a strategy to mitigate these effects.

Purpose of the Study:

  • To assess if phentolamine-induced vasodilation can counteract the detrimental effects of CPB in pediatric patients undergoing cardiac surgery.
  • To evaluate the impact of phentolamine on metabolic and perfusion parameters during and after CPB.

Main Methods:

  • Prospective, randomized clinical study involving 43 pediatric patients with congenital heart disease.
  • Patients received either phentolamine during CPB (Group 1, n=22) or no phentolamine (Group 2, n=21).
  • Measurements included temperature gradients and serum lactate levels before, during, and after CPB; systemic oxygen consumption was also assessed.

Main Results:

  • Phentolamine group showed significantly lower lactate levels post-CPB and at operation end (p < 0.05).
  • Improved central-peripheral temperature uniformity was observed in the phentolamine group during and after CPB (p < 0.05).
  • Systemic oxygen consumption was higher in the phentolamine group post-rewarming (p < 0.05), though mean arterial pressure was lower post-CPB (p = 0.03).

Conclusions:

  • Phentolamine administration during CPB in pediatric cardiac surgery is associated with reduced anaerobic metabolism.
  • Phentolamine appears to promote more uniform body perfusion in this patient population.
  • The findings suggest phentolamine is a potential adjunct for managing CPB-related complications in pediatric congenital heart disease surgery.
Abstract

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