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Medikamentöse Therapie des myokardialen Pumpversagens („low-output failure“)

  • J. Boldt
  • G. Hempelmann
Chapter
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Part of the Anaesthesiologie und Intensivmedizin / Anaesthesiology and Intensive Care Medicine book series (A+I, volume 222)

Zusammenfassung

Das Low-output-Syndrom ist neben dem kardiogenen Schock die schwerste Form der akuten kardiozirkulatorischen Dysfunktion. Der Entwicklung des Low-output-Syndroms in der perioperativen Phase liegt eine Vielzahl pathophysiologischer Entstehungsmechanismen zugrunde; neben einer prädisponierenden Grunderkrankung kann auch die perioperative Begleitmedikation eine wichtige Rolle spielen. Unabhängig von der Ätiologie der zugrundeliegenden Herzerkrankung ist die akute kardiozirkulatorische Insuffizienz von einem erniedrigten Herzzeitvolumen und gleichzeitig erhöhten Spiegeln zirkulierender Katecholamine mit den damit verbundenen Gefahren charakterisiert.

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Literatur

  1. 1.
    Amin KA, Sah PK, Hulse S, Shellock FG, Swan HC (1984) Myocardial metabolic and hemodynamic effects of intravenous MDL 117043, a new cardiotonic drug, in patients with chronic severe heart failure. Am Heart J 108: 1285–1292PubMedCrossRefGoogle Scholar
  2. 2.
    Appleman MM, Beavo JA Jr, Hardman JG, Klee CB, Thompson WJ (1984) A subcommittee for nomenclature recommendations. Adv Cyclic Nucleotide Protein Phosphorylation Res 16: VIGoogle Scholar
  3. 3.
    Bairn DS (1989) Effect of phosphodiesterase inhibition on myocardial oxygen consumption and coronary blood flow. Am J Cardiol 63: 23A - 26ACrossRefGoogle Scholar
  4. 4.
    Boldt J, Kling D, Schuhmann E, Scheld DD, Hempelmann G (1988) Der neue Phosphodiesterase-Hemmer Enoximone im Rahmen herzchirurgischer Eingriffe–Eine vergleichende Untersuchung zu Dobutamin. Herz 13: 335–342PubMedGoogle Scholar
  5. 5.
    Boldt J, Kling D, Moosdorf R, Hempelmann G (1990) Enoximone treatment of impaired myocardial function during cardiac surgery: Combined effects with epinephrine. J Cardiothorac Anesth 4: 462–468PubMedCrossRefGoogle Scholar
  6. 6.
    Braunwald E (1986) Newer positive inotropic agents. Introduction. Curculation [Suppl III] 73: 1111–1113Google Scholar
  7. 7.
    Bristow MR, Ginsburg R, Monobe W, Cubiceiotti RS, Sageman WS (1978) Decreased catecholamine sensitivity and beta-adrenergic receptor density in failing human hearts. N Engl J Med 29: 1373–1377Google Scholar
  8. 8.
    Colucci WS, Wrigth RF, Braunwald E (1986) New positive inotropic agents in the treatment of congestive heart failure, part 1. N Engl J Med 314: 290–299PubMedCrossRefGoogle Scholar
  9. 9.
    Colucci WS, Wright RF, Braunwald E (1986) New positive inotropic agents in the treatment of congestive heart failure, part 2. N Engl J Med 314: 349–358PubMedCrossRefGoogle Scholar
  10. 10.
    Dage RC, Roebel LE; Hsieh CP, Weiner DL, Woodward JK (1982) Cardiovascular properties of a new cardiotonic agent: MDL 17043. J Cardiovasc Pharmacol 4: 500–508PubMedCrossRefGoogle Scholar
  11. 11.
    Dubois-Rande JL, Loisance D, Duval AM et al. (1988) Enoximone–a pharmacological bridge to transplantation. Br J Clin Pract [Suppl 64] 42: 73–79Google Scholar
  12. 12.
    Jarman RH, Brooks JL, Kaplan JA (1979) Dobutamine responses in patients taking propranolol. Anesthesiology 51: S11 1Google Scholar
  13. 13.
    Gonzalez M, Desager JP, Jacquemart JL, Chenu P, Müller T, Installe (1988) Efficacy of enoximone in the management of refractory low-output states following cardiac surgery. J Cardiothorac Anesth 2: 409–418PubMedCrossRefGoogle Scholar
  14. 14.
    Grünnicker M, Hess W (1987) Preliminary results with amrinone in perioperative low cardiac output syndrome. J Thorac Cardiovasc Surg 35: 219–225CrossRefGoogle Scholar
  15. 15.
    Hartmann A, Saeed M, Bing RJ (1986) Phosphodiesterase-Hemmung als neues postitivinotropes Prinzip. Dtsch Med Wochenschr 111: 1971–1977PubMedCrossRefGoogle Scholar
  16. 16.
    Hess W, Bruckner JB, Faber du Faur J von, Schmidt D, Tarnow J (1979) Hämodynamische Wirkungenvon Dobutamin and Dopamin bei Patienten mit koronarer Herzkrankheit. Anaesthesist 28: 316–321PubMedGoogle Scholar
  17. 17.
    Katz AM (1986) Potential deleterious effects of inotropic agents in the therapy of chronic heart failure. Circulation [Supl III] 73:III184-IIIGoogle Scholar
  18. 18.
    Mitrovic V, Thormann J, Neutner J,Bahavar H, Volzu M, Dietrich HA, Schlepper M (1989) Hemodynamic, antiischemic, and neurohumoral effects of enoximone in patients with coronary artery diesease. Am Heart J 117: 106–111PubMedCrossRefGoogle Scholar
  19. 19.
    Piepenbrock S, Hempelmann G, Reichelt W, Stemann T (1979) Hämodynamische and selektiv vaskuläre Effekte von Dobutamin während and nach herzchirurgischen Eingriffen. Anaesthesist 28: 307–315PubMedGoogle Scholar
  20. 20.
    Rettig GF, Bette L (1988) Current therapy of acute heart failure. Cardiovasc Drug Ther 2: 401–406CrossRefGoogle Scholar
  21. 21.
    Roebel LE, Dage RC, Cheng HC, Woodward JK (1982) Characterization of the cardiovascular activities of a new cardiotonic agent, MDL 17043. J Cardiovasc Pharmacol 4: 721–729PubMedCrossRefGoogle Scholar
  22. 22.
    Rutman HI, LeJemtel TH, Sonnenblick EH (1987) Newer cardiotonic agents: implications for patients with heart failure and ischemic heart diesease. J Cardiovasc Anesth 1: 59–70CrossRefGoogle Scholar
  23. 23.
    Scholz H (1984) Inotropic drugs and their mechanism of action. J Am Col Cardiol 4: 389–397CrossRefGoogle Scholar
  24. 24.
    Silver PJ (1989) Biochemical aspects of inhibition of cardiovascular low cyclic adenosinemonophosphate-phosphodiesterase. Am J Cardiol 63: 2A - 8APubMedCrossRefGoogle Scholar
  25. 25.
    Tinker J (1987) Strong inotropes (i. g. epinephrine) should be drugs of first choice during emergence from cardiopulmonary bypass. J Cardiothorac Anesth 3: 256–258CrossRefGoogle Scholar
  26. 26.
    Wilmshurst PT, Thompson DS, Jenkins BS, Coltart DJ, Webb-Peploe MM (1983) Hemodynamic effects of intravenous amrinone in patients with impaired left ventricular function. Br Heart J 49: 49–54Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1992

Authors and Affiliations

  • J. Boldt
  • G. Hempelmann

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