Effects of loprinone hydrochloride on hemodynamics and respiratory oxygenation in patients after cardiac surgery
Unoshima, M.; Iwasaka, H.; Hattori, S.; Kitano, T.; Noguchi, T.
Masui. Japanese Journal of Anesthesiology 46(8): 1053-1058
1997
ISSN/ISBN: 0021-4892 PMID: 9283160 Document Number: 472637
Loprinone hydrochloride (Lop), a phosphodiesterase fraction HI inhibitor and positive inotrope, was recently released in Japan. We evaluated its dose-related effects on hemodynamics and oxygenation as well as on plasma levels of Lop in ten patients after cardiac surgery. Immediately after admission to the intensive care unit, baseline hemodynamics and arterial blood gas data were obtained; patients with inotropic support, were given 0.1, 0.2, 0.3 mu-g cntdot kg-1 cntdot min-1. Lop over 1 hour incrementally, and additional data were obtained. CI increased significantly from baseline (2.1+-0.31 cntdot min-1 cntdot m-2) to 3.2+-0.8 at 0.3 mu-g cntdot kg-1 cntdot min-1. Systemic vascular resistance decreased significantly from baseline (2853+-439 dynes cntdot sec cntdot cm-1 cntdot m-2) to 1554+-440 at 0.3 mu-g cntdot kg-1 cntdot min-1, and mean arterial pressure also decreased significantly from baseline. There were no significant changes in heart rate (HR), central venous pressure (CVP), pulmonary artery occlusion pressure (PAOP), or Pa-O-2 cntdot F-IO-2 cntdot 1 in patients over the period evaluated. Plasma levels of Lop rapidly increased to 27.8 ng-ml-1 (effective level; 20 ng cntdot ml-1) at 0.3 mu-g cntdot kg-1 cntdot min-1. In this study, Lop was shown to effectively increase CI in patients after cardiac surgery with no significant changes in HR, CVP, PAOP or Pa-O-2/F-IO-2. Thus, Lop has a beneficial effect in the treatment of patients with low cardiac output immediately after cardiac surgery.