The perioperative application of vasoconstrictor in patients of congenital heart disease with sever pulmonary arteries hypertension
10.3760/cma.j.issn.1001-4497.2011.07.013
- VernacularTitle:缩血管药物在先天性心脏病合并重度肺动脉高压患者围手术期的应用
- Author:
Shuwen LI
;
Qingyan JIA
;
Weiping CHENG
- Publication Type:Journal Article
- Keywords:
Congenital heart disease;
Pulmonary arteries hypertension (PAH);
Vasoconstrictor;
Systemic vascular resistance
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2012;28(7):425-428
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the curative effects of different ideas for application of vasoactive drugs in patients of congenital heart disease with SPAH during perioperative period and to choose a method to improve the survival rate of patients with high-risk SPAH.Methods Thirty two patients were separated into two groups randomly,one group was treated by vasodilator to dilate the pulmonary artery and decrease the pulmonary pressure as conventional therapeutic strategy,the other was treated by vasoactive drugs to decrease the right cardiac output,which maintain the normal vessel resistance and cardiac output and reduce right heart failure.Indexes were recorded respectively,including hemodynamic,right cardiac working index(RCWI),the time of using respirator and postoperative complications to compare the differences.Results Indexes were recorded in two groups as following:Aortic/pulmonary artery pressure inversion(6.25％ vs.56.25％),RCWI (1626.87 ±411.23 vs.3808.99 ± 275.52),incidence of right heart failure (6.25％ vs.93.75％),respirator applying time[(68.00 ± 7.17) h vs.(115.00 ± 13.68) h],ICU time[(5.0 ± 0.8) d vs.(8.0 ± 1.5) d],incidence of postoperative pulmonary complications (6.25％ vs.81.25％),mortality(0 vs.12.5％).Conclusion The new therapeutic idea that using vasoactive drugs to reduce RCW1 and to maintain peripheral vessel resistance and appropriate cardiac output is superior for postoperative complications and mortality reduction.
