Cardiac performance enhancement from dobutamine in patients refractory to hypervolemic therapy for cerebral vasospasm

M. L. Levy, C. H. Rabb, V. Zelman, S. L. Giannotta

Research output: Contribution to journalArticlepeer-review

91 Citations (Scopus)

Abstract

The use of the beta-agonist dobutamine in combination with hypervolemic preload enhancement of cardiac performance was analyzed in 23 patients who failed to respond to traditional preload enhancement following aneurysmal subarachnoid hemorrhage. The patients ranged in age from 13 to 82 years, and three had a history of cardiac disease. Each patient underwent placement of a flow-directed balloon-tipped catheter and the following measurements were obtained during hyperdynamic therapy: pulmonary artery wedge pressure, central venous pressure, cardiac index, stroke volume index, total peripheral resistance, and left ventricular stroke work index (LVSWI). Mean baseline cardiac function was found to be within normal limits (LVSWI = 47.6 ± 4.2 gm/min/sq m and cardiac index = 3.30 ± 0.22 liter/min/sq m). After baseline measurements were recorded, 5% albumin was infused at 300 cc/hr and dobutamine was initiated at a rate of 5 to 10 μg/kg/hr. This hyperdynamic therapy with dobutamine in the presence of volume loading resulted in a 52% increase in cardiac index, a 15% increase in LVSWI, and a 21% decrease in total peripheral resistance. The clinical reversal of ischemic symptoms due to subarachnoid hemorrhage was evident in 18 (78%) of the 23 patients.

Original languageEnglish
Pages (from-to)494-499
Number of pages6
JournalJournal of Neurosurgery
Volume79
Issue number4
DOIs
Publication statusPublished - 1993
Externally publishedYes

Keywords

  • cardiac index
  • cerebral vasospasm
  • dobutamine
  • pulmonary artery
  • subarachnoid hemorrhage
  • wedge pressure

Fingerprint

Dive into the research topics of 'Cardiac performance enhancement from dobutamine in patients refractory to hypervolemic therapy for cerebral vasospasm'. Together they form a unique fingerprint.

Cite this