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  • Title: [The effects of dobutamine in postoperative disorders of left ventricular function in coronary patients undergoing abdominal surgery. Apropos of 18 cases].
    Author: Nicolas F, Pinaud M, Desjars P.
    Journal: Ann Anesthesiol Fr; 1978; 19(10):869-80. PubMed ID: 35061.
    Abstract:
    Increasing doses of dobutamine were administered to the first group of 10 coronarians having undergone and abdominal surgical procedure, and presenting, one hour after awakening from the anesthesia, hemodynamic modifications with a diminution of cardiac index (CI), systolic index (SI), systolic work index of the left ventricle (SWILV) increase in the pulmonary capillary pressure (PCP), and in the total peripheral resistance (TPR), as well as an acceleration of the cardiac rate (CR). Doses of dobutamine of 5 or 7.5 microgram.kg-1.min-1 corrected the IC, PCP and TPR. Dobutamine ameliorated the SI and SWILV in an increasing fashion up to a dose of 10 microgram.kg-1.min-1 only and without restoring them to the control values of the pre-operative period. CR progressively increased with the increasing of the doses reaching 126 +/- 21.5 beats min-1 for 15 microgram.kg-1.min-1. Extrasystoles appeared at dose levels of 12.5 and 15 microgram.kg-1.min-1 in two patients. Tests of vascular filling (pre-charge tests) carried out in the second group of patients under 10 microgram,kg-1.min-1 of dobutamine and in a third group under 15 microgram.kg-1.min-1 showed a good cardiac adaptation to filling, equal or superior to that of the pre-operative period. It also appeared that the amelioration of CF obtained with a moderate vascular filling (300 ml of low molecular weight dextran) under 10 microgram.kg-1.min-1 of dobutamine is greatly superior to the amelioration obtained by 10 to 15 microgram.kg-1.min-1 of dobutamine.
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