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KMID : 0376219820190040675
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Chonnam Medical Journal
1982 Volume.19 No. 4 p.675 ~ p.681
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The Hemodynamic Effect of Dopamine and Isuprel in Children with Congenital Heart Disease.
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Abstract
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The proper time for and type of surgical treatment of large VSD and severe pulmonary artery hypertension(PAH) have been controversial. Currently, there is a tendency to repair essentially all large VSDs, except some of those with severe obstructive pulmonary vascular disease.
This report was described about the data derived from the short term administration of isoproterenol in.10 patients with VSD and severe PAH and in 1 patient with PDA and severe PAH.
Infusion of isoproterenol decreased PAP, Rp, Rp/Rs ratio and PAd-PWP an average of 11.2 mmHg, 3.5U/P?, 0.17, and 6.9mmHg, respectively, for the whole group (p<0.05).
On the basis of isoproterenol response, the patients could be divided into two groups: A(n=4) and B(n=7). In group A the PAP decreased from 65.5±2.1 to 47.5±4.0mmHg, the Rp from 9.2+0.6 to 4.7±0.7U/m, the Rp/Rs from 0.83±0.03 to 0.56±0.06, and the PAd-PWP from 37.3±1.2 to 27.4±2.5mmHg In group B, a less significant change in these measurements was observed.
Group A patients underwent VSD repair, and the mean average postoperative decrease in PAP was 32.3mmHg (p<0.05).
The hemodynamic affects of dopamine were studied in 3 patient with low cardiac output syndrome early after intracardiac repair.
The RVSP increased from 60.3±2.5 to 68.0+2.6mmHg, the SV from 31.0± 2.6 to 43.0±2.1m1/beat,and Sp from 61.3±4.0 to 73.7±2.1.
Our findings suggest if the preceding hemodynamic parameters improve significantly after infusion of isoproterenol the VSD repair should be performed. And also dopamine appears be a useful agent to augment cardiovascular function children with low cardiac output syndrome.
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