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Ann Thorac Surg 1980;29:26-31
© 1980 The Society of Thoracic Surgeons

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Articles

The Use of Levarterenol and Phentolamine in Patients with Low Cardiac Output Following Open-Heart Surgery

Department of Surgery, Section of Thoracic Surgery, and Department of Anesthesia, University of Michigan Medical Center, Ann Arbor, MI

Accepted for publication February 2, 1979.

^* Address reprint requests to Dr. Kirsh, Section of Thoracic Surgery, C7066 Outpatient, University of Michigan Medical Center, Ann Arbor, MI 48109

A study was made of the hemodynamic effects of levarterenol and phentolamine in patients in whom low cardiac output developed following open-heart operation. After the patients were weaned from cardiopulmonary bypass, the inotropic agents were infused into an external or internal jugular vein through an IVAC pump. Levarterenol was administered first until systolic arterial pressure rose 20 to 30% above the highest recorded preoperative pressure. After stabilization, phentolamine was administered, and infusion rates were adjusted so that arterial blood pressure was returned to levels measured before bypass.

After infusion, all patients showed an increase in cardiac index, mean arterial pressure, mean stroke volume index, and left ventricular stroke work index. Mean pulmonary artery pressure, pulmonary vascular resistance, and left atrial pressure decreased in all patients.

This study demonstrates that hemodynamic improvement occurs in humans in low cardiac output state with simultaneous infusion of levarterenol and phentolamine. We recommend these agents for use in patients with low output, unless they continue to receive propranolol during and after operation. Patients on a regimen of propranolol should not be given levarterenol and phentolamine.

This article has been cited by other articles:

				J. H. Lemmer, M. J. Botham, P. McKenney, R. A. Gerren, M. M. Kirsh, and K. P. Gallagher Norepinephrine plus Phentolarnine Improves Regional Blood Flow during Experimental Low Cardiac Output Syndrome Ann. Thorac. Surg., August 1, 1984; 38(2): 108 - 116. [Abstract] [PDF]