ミトラ弁置換中のニトロプルーシドの全身および肺への影響は,ミトラ弁の嘔吐を患っている患者のミトラ弁置換の際に起こります
D G Lappas1, M Ohtaka, N R Fahmy
1Cardiac Anesthesia Group, Department of Anesthesia, Anaesthesia Laboratory, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Circulation
|September 1, 1978
まとめ
ナトリウムニトロプルシドは,弁置換手術中の重度のミトラルリグルジテーション (MR) 患者の心臓機能を改善しました. この薬は,脳卒中容量を増加させ,充填圧と血管抵抗を低下させ,両心室に利益をもたらした.
科学分野:
- 心血管医学 心血管医学
- 心臓外科手術について
- 薬理学 薬理学とは
背景:
- 重度のミトラル反発 (MR) は,心臓外科手術中に重要な課題を提示します.
- 血液動力学的管理を理解することは,ミトラル弁置換手術を受ける患者にとって非常に重要です.
研究 の 目的:
- ミトラ弁置換手術中の重症MR患者の全身および肺循環に対するナトリウムニトロプロシドの効果を評価する.
- 静脈機能と血管抵抗に対するニトロプロシドの影響を評価する.
主な方法:
- 17人の重度のMR患者で,ミトラル弁の置換手術を受けた.
- ナトリウムニトロプロシドは,手術中に10-65mcg/minの輸液速度で投与されました.
- 血動力学的パラメータは,脳卒中容量,充填圧,血管抵抗など,モニタリングされました.
主要な成果:
- ナトリウムニトロプロシドは,前方ストロークの体積 (34〜46ml) を増加させ,左心室の充填圧 (28.7〜20.6mm Hg) を減少させた.
- システム血管抵抗は2379から1646ダイネス.秒.cm-5に低下し,肺血管抵抗は414から208ダイネス.秒.cm-5に低下した.
- 平均動脈圧,平均肺動脈圧,肺毛細血管圧のピークV波の有意な低下が観察されました.
結論:
- ナトリウムニトロプロシドの慎重な手術内使用は,ミトラ弁置換手術を受ける重度のMR患者において,右心室と左心室の機能を改善します.
- この薬は,前方ストロークの容量を効果的に増加させ,プレロードとアフターロードを軽減します.
- ナトリウムニトロプロシドは,この患者集団における血液動力学的管理のための貴重なツールです.
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