TREATMENT OF THE LOW-OUTPUT-SYNDROME WITH URAPIDIL AND DOBUTAMINE

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  • 1 January 1981
    • journal article
    • research article
    • Vol. 30  (1) , 22-27
Abstract
Patients (12) suffering from a low cardiac output syndrome following aorto-coronary bypass graft surgery were treated with a combined therapy. The left ventricular afterload was decreased by Urapidil and a low dose positive inotropic agent, dobutamine, was added. The right and left ventricular filling pressures were kept constant by simultaneous volume replacement. Decreasing the mean arterial pressure by Urapidil alone from 122 .+-. 5 mm Hg to 90 .+-. 3 mm Hg raised the cardiac index from 1.8 l/m2 .times. min to 2.7 l/m2 .times. min. By addition of dobutamine 5 .mu.g/kg body weight .times. min the cardiac index was further increased to 3.4 l/m2 .times. min. The heart-rate was unchanged. The pressure-rate-product was decreased by 25% with Urapidil alone (P < 0.01) and was slightly increased after addition of dobutamine. In the patients studied reduction of the mechanical load on the heart by Urapidil in combination with positive inotropic stimulation of the myocardium by dobutamine improved cardiac hemodynamics without a significant detrimental effect on the myocardial O2 balance.