[Enoximone in the postoperative phase of heart surgery]

Ten patients with low cardiac output syndrome (LCOS, cardiac index [CI] = 1.8 +/- 0.24 L.min-1.m-2, pulmonary artery occlusion pressure [PAOP] = 19 +/- 4 mmHg, systolic arterial pressure [APsys] = 76 +/- 5 mmHg) were treated with catecholamines and nitroglycerin. This therapy achieved stable hemodynamic conditions (CI 2.5 +/- 0.2 L.min-1.m-2, PAOP 14 +/- 5 mmHg, APsys = 110 +/- 17 mmHg). Addition of enoximone (bolus dose 1.0 mg.kg-1 followed by continuous infusion of 7 micrograms.kg-1.min-1) induced an increase of CI to 3.6 +/- 1.3 L.min-1.m-2 (p < 0.05) and of left ventricular stroke work index (LVSWI) from 21.8 +/- 3.6 g.m.m-2 to 29.3 +/- 10.1 g.m.m-2 (p < 0.05). Systemic vascular resistance decreased from 1300 +/- 415 dyn.s.cm-5 to 972 +/- 390 dyn.s.cm-5 (p < 0.01). No alterations of heart rate, mean arterial or pulmonary arterial pressure and PAOP were observed. Likewise, enoximone had no effect on gas exchange. Oxygen consumption index (VO2I) was elevated from 83 +/- 22 mL.min-1.m-2 to 126 +/- 31 mL.min-1.m-2 (p < 0.01) and oxygen delivery index (DO2I) increased from 348 +/- 112 mL.min-1.m-2 to 498 +/- 206 mL.min-1.m-2 (p < 0.05). In contrast, oxygen extraction ration remained unchanged (29 +/- 10% n.s.). Oxygen consumption and delivery were significantly lower during treatment of LCOS with catecholamines and nitroglycerin when compared with a matched group of patients without postoperative cardiac failure.(ABSTRACT TRUNCATED AT 250 WORDS)