開心術後急性期における塩酸オルプリノン持続静注の効果

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  • Hemodynamic Effects of Continuous Intravenous Administration of Olprinone Hydrochloride Early after Open-Heart Surgery.
  • カイシンジュツ ゴ キュウセイキ ニ オケル エンサン オルプリノン ジゾク ジョウチュウ ノ コウカ

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Aims : We investigated the effects of intravenous administration of olprinone hydrochloride (Olprinone), a phosphodiesterase III inhibitor, early after open-heart surgery.<BR>Materials & Methods : Thirteen adult patients undergoing cardiac surgery with a postoperative pulmo-nary capillary pressure of greater than 10mmHg were administered Olprinone intravenously at 0.3μ g/kg/ min. Hemodynamics and the plasma concentration of Olprinone were monitored throughout this study.<BR>Results : Heart rates tended to increase immediately after administration and peaked significantly highly after 120 minutes. Systemic blood pressure tended to decrease, but, pulmonary arterial pressure remained unchanged. Cardiac output tended to increase slightly 120 minutes after administration, while pulmonary capillary wedged pressure and central venous pressure decreased significantly. The systemic vascular resistance index tended to decrease, but the pulmonary vascular resistance index remained unchanged. Although the left ventricle stroke work index tended to decrease, the right ventricle stroke work index remained unchanged. The pH and base excess increased significantly after administration. Mixed venous oxygen saturation tended to increase. The plasma concentration of Olprinone increased to effective plasma levels 60 minutes after administration, and reached twice levels of 60 minutes, 240 minutes after administration.<BR>Conclusions : Early after open-heart surgery, intravenous infusion of Olprinone reduced both preload and afterload, and improved cardiac performance. The administration of Olprinone is effective for patients with congestive heart failure, but high-dose administration should be considered carefully for patients with hypovolemia because of potential excessive hypotension.

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