Effects of olprinone on systemic and cerebral circulation in patients with subarachnoid hemorrhage

Olprinone is a promising new drug used for treating cerebral vasospasm. To clarify the effects of olprinone on systemic and cerebral circulation in patients with subarachnoid hemorrhage, hemodynamic and oxygenation parameters were evaluated as 12 such patients underwent surgery. After aneurysm clipping and confirmation of hemostasis, olprinone was administrated at a dose of 10 microg/kg over 5 minutes followed by 0.2 microg/kg/min for 25 minutes. Variables before and after administration were compared by paired t tests. Heart rate and cardiac index increased while no significant changes occurred in oxygen saturation of mixed venous blood, or oxygen extraction ratio. Cortical blood flow increased and cerebral vascular resistance decreased significantly, but oxygen saturation in the jugular bulb, arterio-jugular difference of oxygen content, and lactate oxygen index did not change significantly. In conclusion, olprinone increased cardiac output and cortical blood flow in patients with subarachnoid hemorrhage, but the balance between oxygen supply and consumption systemically and in the brain did not change. This observation suggests the possibility that olprinone increases cerebral metabolism.