[Enoximone in postoperative "low-output syndrome"--comparison with dobutamine]

Abstract

Low output syndrome sometimes complicates early postoperative states following cardiac surgery. A comparative study of hemodynamic responses to enoximone and dobutamine was carried out in two groups of 20 patients each, during a 22-24 hour postoperative observation period. Enoximone, 1 mg/kg i.v. total dose, was given in the first 20 minutes. The infusion was then reduced to 2-10 micrograms.kg-1.min-1 for the next 22-24 hours. Dobutamine was administered in a dose of 4-7 micrograms.kg-1.min-1 over the same period. After 15 minutes of therapy with enoximone cardiac index increased by 42% (initial value 2.31 +/- 0.34 l/min/m2), after 30 minutes by 50%, after 120 minutes by 65% and after 24 hours by 91% from the initial value. At the same time the pulmonary capillary wedge pressure decreased from the initial value of 15.21 +/- 1.65 mmHg by 20%, 25%, 26% and by 43% (22 hours). After dobutamine cardiac index increased from 2.23 +/- 0.6 l/min/m2 by 30% (15 minutes), 47% (30 minutes), 57% (2 hours) and by 85% (22 hours). The pulmonary capillary wedge pressure decreased from 15.70 +/- 3.14 mmHg by 13% (15 minutes), 17% (30 minutes), 22% (2 hours) and by 43% (22 hours). The enoximone group showed a diminution of systolic arterial pressure of 14% in the first 120 minutes, with a return to initial values after 22 hours. Dobutamine produced an increase in systolic arterial pressure of 23% after 2 hours, maintaining increased values of approximately 20% during the observation period. Heart rate increase slightly in both groups in a similar way.(ABSTRACT TRUNCATED AT 250 WORDS)