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Amrinone versus dopamine-nitroglycerin after reconstructive surgery for complete atrioventricular septal defect
P Laitinen1, J M Happonen, H Sairanen
1Department of Anesthesiology, Hospital for Children and Adolescents, University of Helsinki, Finland.
Journal of Cardiothoracic and Vascular Anesthesia
|December 31, 1997
Summary
Amrinone improved cardiac output and oxygen dynamics in infants after heart surgery compared to dopamine and nitroglycerin. This study found amrinone to be a safer and more effective treatment option for these pediatric patients.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Pharmacology
Background:
- Infants undergoing reconstructive surgery for congenital heart disease often require hemodynamic support.
- Conventional treatments include inotropic agents and vasodilators like dopamine and nitroglycerin.
Purpose of the Study:
- To compare the efficacy and safety of amrinone versus a combination of dopamine and nitroglycerin in infants post-congenital heart surgery.
- To evaluate hemodynamic parameters and oxygen dynamics in these infants.
Main Methods:
- A prospective, randomized, double-blind study was conducted in a pediatric intensive care unit.
- Thirty-two infants with complete atrioventricular septal defect were enrolled.
- Patients received either amrinone or a combination of dopamine and nitroglycerin before separation from cardiopulmonary bypass.
Main Results:
- Amrinone administration resulted in a higher systemic and pulmonary blood flow index compared to dopamine-nitroglycerin.
- Oxygen extraction ratio was more favorable with amrinone.
- Despite lower platelet counts, amrinone did not lead to hemorrhagic complications.
Conclusions:
- Amrinone, at the studied dosage, offers superior hemodynamic support, improved oxygen dynamics, and reduced pulmonary vascular resistance in infants post-congenital heart surgery.
- Amrinone demonstrates a favorable safety profile in this patient population.