Post-operative effects of olprinone after coronary artery bypass grafting.

ABSTRACT

The aim of this study was to test the effects of olprinone after coronary artery bypass grafting (CABG). In order to prevent hypotension caused by olprinone, low doses of catecolamines were used concomitantly. Total 22 elective CABG cases were evaluated. In all cases, moderate hypothermia and cardioplegic cardiac arrest were performed. In 10 cases, continuous intravenous 0.1 microg/kg/min of olprinone, 3 microg/kg/min of dobutamine (DOB) and dopamine (DOA) as the initial doses, were used concomitantly (Group I). As a control, the same initial doses of catecolamine (DOB and DOA) of Group I were administered in another 12 patients (Group II). When the pump flow of cardiopulmonary bypass (CPB) was decreased to half, these drugs were administered in both groups. Hemodynamics were recorded before CPB, just after the operation and 3, 6, 12, 24, 48, and 72 hours after the operation. Three hours after the operation, both mean aortic pressure (AoP) and pulmonary artery pressures (PAP) of Group I demonstrated significantly lower values than those of Group II. Cardiac index (CI) of Group I showed significantly higher values than that of Group II until 6 hours after surgery. The systemic vascular resistance index (SVRI) of Group I indicated a significantly lower value than that of Group II until 24 hours after the operation. Pulmonary capillary wedge pressure (PCWP) of Group I demonstrated a significantly lower value than that of Group II. There were no significant differences in urine output, oxygen delivery (DO2) and oxygen consumption (VO2) between both groups. Olprinone increased CI and decreased SVRI, and it showed easy weaning from CPB, demonstrating excellent hemodynamics after CABG. These results suggested that this new phosphodiesterase inhibitor may be effective for not only weaning from CPB but also post-cardiotomy cardiogenic shock.