| Author/Editor | Podbregar, Matej | |
| Title | Primerjava hemodinamskega učinka nizkega odmerka in infuzije enalaprilata pri neodzivnem kroničnem srčnem popuščanju | |
| Type | monografija | |
| Place | Ljubljana | |
| Publisher | Medicinska fakulteta | |
| Publication year | 1997 | |
| Volume | str. 42 | |
| Language | slo | |
| Abstract | OBJECTIVE: To determine effects of low dose enalaprilat on haemodynamics and systemic oxygenation in chronic heart failure refractory to inotropic, vasodilator and diuretic therapy. DESIGNE: Prospective, randomized, clinical stady. SETTING: Medical intensive care unit at a General Hospital. PATIENTS: 20 patients with chronic heart failure due to ischemic heart disease refractory to inotropic, vasodilator and diuretic therapy. INTERVENTIONS: Enalaprilat intravenous ( 0.004 mg/kg) was given in bolus or continuous over one hour. MEASUREMENTS AND MAIN RESULTS: Systemic haemodynamic parameters and systemic oxygenation were recorded at baseline ((+0min), +30 mins, +60 mins, +120 mins, +180 mins, and +360 mins after the start of the intervention. Mean arterial pressure reduction in continuous group was significantly longer and persisted during the study in comparison to bolus group (p < 0.0435). Pulmonary artery occlusion pressure was equally reduced in both groups (p < 0.00001). Cardiac index did not change. Oxygen extraction ratio (ER) was decreased in both groups (p < 0.026). ER decreased for a significantly longer period of time in continuous group comparing to bolus group (p < 0.0169). CONCLUSION: Low dose of enalaprilat ( 0.004 mg/kg) can improve haemodynamic and systemic oxygenation variables in patients with chronic heart failure due to ischemic heart disease refractory to inotropic, vasodilator and diuretic therapy. Haemodynamic effects after bolus enalaprilat were earlier and shorter lasting comparing to continuous group. The most important difference was noticed in prolonged improvement of systemic oxygenation in continuous group. The enalaprilat does not worsen arterial oxygenation as do most other vasodilators. The enalaprilat effect is dependent not only on the dose but also on the mode of application. (Abstract truncated at 2000 characters). | |
| Descriptors | HEART FAILURE, CONGESTIVE ENALAPRILAT HEMODYNAMICS INTENSIVE CARE UNITS INFUSIONS, INTRAVENOUS RANDOMIZED CONTROLLED TRIALS BLOOD PRESSURE HYPOTENSION ECHOCARDIOGRAPHY ELECTROCARDIOGRAPHY CATHETERIZATION, PERIPHERAL CATHETERIZATION, CENTRAL VENOUS |