F. Kunimoto et al., Comparison of the hemodynamic effects of amrinone in patients who requiredlow-to-moderate-dose and high-dose catecholamines after cardiac valve replacement, CRIT CARE M, 27(12), 1999, pp. 2698-2702
Objectives: To determine hemodynamic response to amrinone in patients after
cardiac surgery, in relation to the postoperative cardiac function, which
was indicated by the required doses of catecholamines.
Design: Prospective clinical study.
Setting: Surgical intensive care unit in a university hospital.
Patients: Fourteen patients who required a low-to-moderate dose of dopamine
and dobutamine (group L) and 14 patients who required a high dose of dopam
ine and dobutamine (group H) after cardiac valve replacement,
Interventions: A loading dose of amrinone (0.75 mg/kg) was administered dur
ing a 15-min period and the continuous infusion was followed incrementally
by doses of 5, 10, and 20 mu g/kg/min every 60 mins on the first postoperat
Measurements and Main Results: Hemodynamic variables were determined by the
radial and pulmonary artery catheters at a dose of 0, 5, 10, and 20 mu g/k
g/min. Two-way repeated-measures analysis of variance showed significant in
teraction in the two groups in cardiac index and mean systemic arterial pre
ssure, Cardiac index increased in a dose-dependent manner in group L but wa
s unchanged in group H. Systemic vascular resistance index decreased in a d
ose-dependent manner in both groups. The mean systemic arterial pressure de
creased in group L at a dose of 5 mu g/kg/min and returned to the baseline
level at doses of 10 and 20 mu g/kg/min. On the other hand, the mean system
ic arterial pressure significantly decreased in group H at a dose of 20 mu
Conclusions: The inotropic effects of amrinone after cardiac valve replacem
ent may be associated with the postoperative myocardial reserve, which was
indicated by the required doses of catecholamines, although a similar vasod
ilative effect was observed in both groups.