Efficacia dell'enoximone in pazienti con grave disfunzione ventricolare sinistra sottoposti a bypass aorto-coronarico.

Translated title of the contribution: The effectiveness of enoximone in patients with serious left ventricular dysfunction submitted for aorto-coronary bypass

M. Oppizzi, E. Montorsi, A. Tosoni, V. Casati, M. Venturino, A. Franco, C. Gerli, G. Paolillo

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

BACKGROUND: The purpose of this study was to investigate whether the combined positive inotropic and vasodilating properties of enoximone have a short-term benefit when used in patients who underwent open heart surgery. METHODS: From 7/1994 to 1/1995 twenty-six patients with severe myocardial dysfunction (ejection fraction <35%) were enrolled into a prospective trial before undergoing coronary artery bypass graft. They were randomly selected into two study groups: the first treated with enoximone (group E) and the other one with dopamine (group D). Anaesthesia was the same for both groups using high-dose fentanyl. Buckberg cardioplegia was used. All patients were followed by: conventional monitoring, Swan-Ganz catheter and transesophageal echocardiography. measurements (hemodynamic parameters, end-systolic and diastolic area and left ventricular wall motion) were recorded: after induction of anesthesia, after loading-dose and an intensive care unit. Enoximone- and dopamine infusions were started during weaning from cardiopulmonary bypass and tailored to hemodynamic parameters (cardiac index > 2.8 l/min, wedge pressure <16 mmHg, mixed venous blood saturation > 65%). Major events were defined as: endotracheal intubation > 36 h, using intraortic balloon pump or centrifugal pump, intensive care timer > 48 h, in hospital cardiac death. Prices, were established by DRG-tables (diagnosis related groups). Statistical analysis were performed by X and "t" Student tests. RESULTS: Cardiac index increased more significantly in group E (CI 1.9-->3.9 vs 2.3-->3.3; p 0.05) thanks to a higher reduction of vascular systemic (SVRI 2889-->1447 vs 2536 -->1565; p 0.005) and pulmonary resistances (PVRI 271-->193 vs 288-->218; p 0.05). Fewer major cumulative events and intensive care costs were observed in group E rather than group D. CONCLUSIONS: Enoximone administer immediately after open heart surgery had more beneficial hemodynamic and clinical effects than dopamine in patients with severe left ventricular dysfunction.

Original languageItalian
Pages (from-to)17-27
Number of pages11
JournalMinerva Anestesiologica
Volume63
Issue number1-2
Publication statusPublished - Jan 1997

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Enoximone
Left Ventricular Dysfunction
Diagnosis-Related Groups
Critical Care
Thoracic Surgery
Pulmonary Wedge Pressure
Intratracheal Intubation
Blood Vessels
Dopamine
Hemodynamics
Students
Costs and Cost Analysis
Lung

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Oppizzi, M., Montorsi, E., Tosoni, A., Casati, V., Venturino, M., Franco, A., ... Paolillo, G. (1997). Efficacia dell'enoximone in pazienti con grave disfunzione ventricolare sinistra sottoposti a bypass aorto-coronarico. Minerva Anestesiologica, 63(1-2), 17-27.

Efficacia dell'enoximone in pazienti con grave disfunzione ventricolare sinistra sottoposti a bypass aorto-coronarico. / Oppizzi, M.; Montorsi, E.; Tosoni, A.; Casati, V.; Venturino, M.; Franco, A.; Gerli, C.; Paolillo, G.

In: Minerva Anestesiologica, Vol. 63, No. 1-2, 01.1997, p. 17-27.

Research output: Contribution to journalArticle

Oppizzi, M, Montorsi, E, Tosoni, A, Casati, V, Venturino, M, Franco, A, Gerli, C & Paolillo, G 1997, 'Efficacia dell'enoximone in pazienti con grave disfunzione ventricolare sinistra sottoposti a bypass aorto-coronarico.', Minerva Anestesiologica, vol. 63, no. 1-2, pp. 17-27.
Oppizzi M, Montorsi E, Tosoni A, Casati V, Venturino M, Franco A et al. Efficacia dell'enoximone in pazienti con grave disfunzione ventricolare sinistra sottoposti a bypass aorto-coronarico. Minerva Anestesiologica. 1997 Jan;63(1-2):17-27.
Oppizzi, M. ; Montorsi, E. ; Tosoni, A. ; Casati, V. ; Venturino, M. ; Franco, A. ; Gerli, C. ; Paolillo, G. / Efficacia dell'enoximone in pazienti con grave disfunzione ventricolare sinistra sottoposti a bypass aorto-coronarico. In: Minerva Anestesiologica. 1997 ; Vol. 63, No. 1-2. pp. 17-27.
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abstract = "BACKGROUND: The purpose of this study was to investigate whether the combined positive inotropic and vasodilating properties of enoximone have a short-term benefit when used in patients who underwent open heart surgery. METHODS: From 7/1994 to 1/1995 twenty-six patients with severe myocardial dysfunction (ejection fraction <35{\%}) were enrolled into a prospective trial before undergoing coronary artery bypass graft. They were randomly selected into two study groups: the first treated with enoximone (group E) and the other one with dopamine (group D). Anaesthesia was the same for both groups using high-dose fentanyl. Buckberg cardioplegia was used. All patients were followed by: conventional monitoring, Swan-Ganz catheter and transesophageal echocardiography. measurements (hemodynamic parameters, end-systolic and diastolic area and left ventricular wall motion) were recorded: after induction of anesthesia, after loading-dose and an intensive care unit. Enoximone- and dopamine infusions were started during weaning from cardiopulmonary bypass and tailored to hemodynamic parameters (cardiac index > 2.8 l/min, wedge pressure <16 mmHg, mixed venous blood saturation > 65{\%}). Major events were defined as: endotracheal intubation > 36 h, using intraortic balloon pump or centrifugal pump, intensive care timer > 48 h, in hospital cardiac death. Prices, were established by DRG-tables (diagnosis related groups). Statistical analysis were performed by X and {"}t{"} Student tests. RESULTS: Cardiac index increased more significantly in group E (CI 1.9-->3.9 vs 2.3-->3.3; p 0.05) thanks to a higher reduction of vascular systemic (SVRI 2889-->1447 vs 2536 -->1565; p 0.005) and pulmonary resistances (PVRI 271-->193 vs 288-->218; p 0.05). Fewer major cumulative events and intensive care costs were observed in group E rather than group D. CONCLUSIONS: Enoximone administer immediately after open heart surgery had more beneficial hemodynamic and clinical effects than dopamine in patients with severe left ventricular dysfunction.",
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AU - Oppizzi, M.

AU - Montorsi, E.

AU - Tosoni, A.

AU - Casati, V.

AU - Venturino, M.

AU - Franco, A.

AU - Gerli, C.

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