Dobutamine (Total 6534 Papers Found)

The inotropic agents, dopamine (DP) and dobutamine (DB), both decrease PaO2, probably by a resistribution of the $${{\dot VA} \mathord{\left/ {\vphantom {{\dot VA} {\dot Q}}} \right. \kern-\nulldelimiterspace} {\dot Q}}$$ ratio. The aim of this study was to assess the effect of both drugs on the $${{\dot VA} \mathord{\left/ {\vphantom {{\dot VA} {\dot Q}}} \right. \kern-\nulldelimiterspace} {\dot Q}}$$ ratio, using the multiple inert gas elimination method. Ten artificially ventilated patients ( ...
OBJECTIVES This study was designed to compare exercise, dipyridamole and dobutamine echocardiography in the same patients and to evaluate, by measuring physiologic and echocardiographic variables, the mechanisms by which exercise and dobutamine induce ischemia. BACKGROUND The diagnostic value of stress echocardiography has been widely reported, but the specific effects of exercise, dipyridamole and dobutamine have not been directly compared. Furthermore, no echocardiography study has evaluated ...
Up to 2008, dopamine was the catecholamine that was the most recommended in our intensive care unit (ICU) after fluid resuscitation. However, recently, norepinephrine has become the catecholamine that was most recommended in our ICU after fluid resuscitation. The aim of this study was to determine if there was an efficacy or safety benefit to this protocol therapeutic change in patients with shock admitted to our ICU. The primary outcome variable was ICU mortality. This is a prospective observat ...
The main cause of death for diabetic patients and patients on dialysis is coronary artery disease (CAD). The most common cause of graft loss following simultaneous pancreas and kidney transplantation (SPK) is death with a functioning graft due to CAD. Therefore, careful pretransplantation evaluation of CAD is mandatory. In our series, every patient undergoes a noninvasive cardiac function test like dobutamine stress echocardiography (DSE) or myocardial thallium scintigraphy using adenosine to in ...
The purpose of this study was to assess the effects of low-dose dobutamine on left ventricular (LV) functional and coronary flow reserves using transthracic echocardiography. The study group consisted of 30 children aged from 5 months to 16 years (mean 4.8 +/- 4.4 years). Echocardiographic studies were repeated before and during dobutamine infusion (5 microg/kg per minute). The peak diastolic velocity in the left descending coronary artery (LAD) was recorded by pulsed-Doppler under the guidance ...
Left ventricular end-systolic pressure-dimension relation (ESPDR) was generated by the transient occlusion of the inferior vena cava (IVC) or thoracic aorta (AO) in 13 anesthetized open-chest dogs, while the left ventricular pressure was measured by a TP-200T pressure transducer and the anterior-posterior dimension was measured by a pair of ultrasonic crystal implanted in the endocardium and recorded by a Sonomicrometer. The results showed that: (1) the ESPDR was shown to be linear, unaltered by ...
OBJECTIVE To determine the predictive values of noninvasive tests for the detection of allograft vascular disease. METHODS We studied 39 patients with mean ages of 48+/-13 years and a follow-up period of 86+/-13 months. The diagnosis of allograft vascular disease was made by cine-coronary arteriography, and it was considered as positive if lesions existed that caused > or =50% obstruction of the lumen. Patients underwent 24h Holter monitoring, thallium scintigraphy, a treadmill stress test, ...
Heart transplantation (HTx) candidates who remain severely symptomatic despite optimal therapy are normally hospitalized. Continuous infusion of intravenous drugs from a portable pump may allow such patients to live fairly active life until a donor heart is found. Among the current potential bridging agents the synthetic β-agonist dobutamine is preferred for inotropic support. Prostaglandin E1 (PGE1), a naturally occurring substance with an eicosanoid structure and potent pulmonary and systemic ...
Sepsis is the leading cause of death in critically ill patients, and its incidence continues to rise. Sepsis was defined as a systemic inflammatory response syndrome with an identifiable focus of infection, but therapeutic strategies aimed at eliminating the inflammatory response have only modest clinical benefit. The development of a failure of one or more organs poses a major threat to the survival of patients with sepsis, and mortality in sepsis is most often attributed to multiple organ dysf ...
BACKGROUND The phase-space relationship between simultaneously measured myoplasmic [Ca2+] and isovolumetric left ventricular pressure (LVP) in guinea pig intact hearts is altered by ischemic and inotropic interventions. Our objective was to mathematically model this phase-space relationship between [Ca2+] and LVP with a focus on the changes in cross-bridge kinetics and myofilament Ca2+ sensitivity responsible for alterations in Ca2+-contraction coupling due to inotropic drugs in the presence and ...
The cardiovascular changes following portosystemic shunt surgery (PSSS) in 33 children with extrahepatic portal hypertension (EPH) were studied to determine if portosystemic shunt surgery had any influence on the cardiovascular state. Haemodynamic data were obtained using two-dimensional and M-mode echocardiography, pulsed-wave Doppler and direct invasive techniques. Postoperatively all patients developed a hyperdynamic state, associated with an increase in cardiac index (CI), heart rate (HR) an ...
OBJECTIVE To compare the efficacy and safety of domestic levosimendan versus dobutamine for patients with acute decompensated heart failure (ADHF). METHODS ADHF patients from 8 medical centers were recruited in this multicenter, blind, positive-controlled, randomized study and received 24 h intravenous levosimendan (n = 114) or dobutamine (n = 114) therapy. SWAN-GANZ catheter was performed in patients with pulmonary capillary wedge pressure (PCWP) ≥ 15 mm Hg (1 mm Hg = 0.133 kPa) and cardiac ...
OBJECTIVE Dobutamine is the currently recommended β-adrenergic inotropic drug for supporting sepsis-induced myocardial dysfunction when cardiac output index remains low after preload correction. Better and safer therapies are nonetheless mandatory because responsiveness to dobutamine is limited with numerous side effects. Apelin-13 is a powerful inotropic candidate that could be considered as an alternative noncatecholaminergic support in the setting of inflammatory cardiovascular dysfunction. ...
Sirs, In heart failure, heart rate (HR) is related to cardiac decompensations and overall mortality [1]. Low baseline HR and HR reduction by beta-blockers are significantly associated with a better prognosis [1, 2]. Currently in acute heart failure the inotrope dobutamine is frequently used to increase cardiac output and to lower filling pressures [3]. Dobutamine stimulates myocardial ß1-adrenergic receptors thereby improving myocardial contractility and reducing wall stress. Sometimes increase ...
BACKGROUND The implications of hypotension occurring during dobutamine stress echocardiography have not been elucidated. We observed in some patients that hyperdynamic left ventricular function developed during dobutamine stress echocardiography and hypothesized that intracavitary obstruction was occurring and might account for hypotension in some patients. METHODS AND RESULTS Fifty-seven consecutive patients undergoing dobutamine stress echocardiography underwent pulsed-wave and continuous-wa ...
Epinephrine-induced hypokalemia appears to be mediated by beta 2-agonist activation of Na+/K+ ATPase. To determine whether dopamine and dobutamine induce hypokalemia, eight adult mongrel dogs were anesthetized and studied in random crossover fashion. Potassium [K+] was measured with an ion-selective microelectrode, and central hemodynamics were measured continuously. After stabilization, dopamine and dobutamine were infused at doses of 2, 4, 8, and 20 micrograms/kg/min (15-min increments/dose), ...
Experiments with the dopamine-congener dobutamine were performed on isolated, spontaneously beating right atria as well as on electrically driven left atria of guinea pigs (2 and 3 Hz). Furthermore, its relaxant effect on the tracheal chain was investigated. 1. On right atria dobutamine caused a positive chronotropic effect, the corresponding pD2-value was by 1.75 log units lower than that determined for isoprenaline. The intrinsic activity (isoprenaline=1) was 0.79 for the increase in rate. The ...
PURPOSE To combine three magnetic resonance (MR) imaging modalities-dobutamine stress cine, first pass, and late contrast material-enhanced T1-weighted imaging-and to compare the results with 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in the assessment of unviable myocardium in coronary artery disease. MATERIALS AND METHODS Ten patients with multivessel coronary artery disease underwent MR imaging before and 6 months after bypass surgery. Left ventricular ...
BACKGROUND Thallium-201 stress imaging is the most often used noninvasive test for detection of coronary artery disease. Its utility in patients with end-stage lung disease has not been defined. METHODS Feasibility, safety, and reliability of thallium 201 perfusion imaging was evaluated in 23 consecutive candidates for lung transplantation. All underwent graded dobutamine thallium 201 single photon emission computed tomography imaging. The perfusion imaging results were correlated with results ...
BACKGROUND The aim of this study was to evaluate the cardioprotective effects of bone marrow-derived stem cells on myocardial compliance in a chronic ischemia model regarding strain rate (SR) parameters during dobutamine stress echocardiography (DSE). METHODS Ameroid constrictors were placed around the circumflex arteries of 23 domestic pigs to induce chronic vessel occlusions. Fifteen pigs received transendocardially bone marrow derived stem cells, and 8 received placebo injections (a 0.9% so ...
  • P. M. Taylor,
  • Journal of veterinary pharmacology and therapeutics
  • 1998
The study was designed to contribute to identification of the stimulus to adrenocortical activity during halothane anaesthesia in equidae. Two groups of six ponies were premedicated with acepromazine before induction of anaesthesia with thiopentone and maintenance for 120 min with halothane in oxygen. In group H Haemaccel modified gelatine plasma replacer was infused (48+/-13 mL/kg) to maintain mean arterial blood pressure (MABP) close to preanaesthetic values. In group DH, blood pressure was ma ...
OBJECTIVE To determine whether catecholamines with different adrenergic receptor affinities are characterized by individual relationships between cardiac output (Q) and oxygen consumption (VO2). DESIGN Comparison of the dose-effect relationships and Q/VO2 relationships of four different catecholamines in the same awake dogs. SETTING University research department of experimental anesthesiology. SUBJECTS Ten trained, healthy dogs in the basal metabolic state with chronically implanted ultra ...
Precise determination of left and right ventricular stroke volumes is limited with conventional imaging techniques. We determined whether right and left ventricular stroke volumes could be precisely measured with cine computed tomography (CT). Cine CT enables simultaneous imaging of the right and left ventricles at an 8 mm slice thickness with a maximal scanning rate of 17 frames/sec (50 msec acquisition intervals). In eight dogs, true right ventricular and left ventricular stroke volumes were d ...
BACKGROUND Patients with ST-elevation myocardial infarction (STEMI) not treated with primary or rescue percutaneous coronary intervention (PCI) are at risk for recurrent ischemia, especially when viability in the infarct-area is present. Therefore, an invasive strategy with PCI of the infarct-related coronary artery in patients with viability would reduce the occurrence of a composite end point of death, reinfarction, or unstable angina (UA). METHODS Patients admitted with an (sub)acute myocar ...
Die kardiovaskuläre Magnetresonanztomographie (MRT) bietet die Möglichkeit, Morphologie, Funktion, Perfusion und den Nachweis von myokardialem Narbengewebe in einem Untersuchungsvorgang zu vereinen. Zudem kommt die kardiovaskuläre MRT ohne Strahlenbelastung aus. Belastungsformen mittels MRT sind zum einen die Perfusionsuntersuchung, in der Regel mit Adenosin, oder aber die Wandbewegungsanalyse mit Dobutamin. Anderen bildgebenden Belastungsuntersuchungen wie der Stressechokardiographie oder My ...
Despite the evaluation of different parameters of myocardial viability by PET, TEE and MRI, their positive and negative predictive accuracies are fairly comparable. Therefore, the choice of the method to date mainly depends on expertise and available resources. An accepted reference standard to assess the diagnostic accuracy of imaging techniques is the post-revascularization recovery of regional LV function. In this respect, dobutamine-MRI proved to be a reliable and clinically feasible approac ...
OBJECTIVES Early evaluation of myocardial viability in acute myocardial infarction is useful to guide therapy. Therefore, we assessed 64-slice computed tomography (CT) immediately after coronary angiography in this setting. BACKGROUND Recent preliminary studies have shown the promising usefulness of late hyperenhancement multislice computed tomography (MSCT) for non-viability assessment. METHODS Thirty-six patients admitted for a first acute myocardial infarction had a coronary angiogram ear ...
The purpose of our study was to compare the ability of dobutamine and dipyridamole infusion to induce myocardial ischemia. In a population of 16 anesthetized open-chest swine, a coronary artery stenosis sufficient to abolish the hyperemic response to a 15-second total occlusion was created. Heart rate, systolic blood pressure, and dP/dt were recorded. Myocardial segment shortening was determined by sonomicrometry in all animals. In a subset of seven animals regional myocardial blood flow was mea ...
  • ,
  • 2004
Objectives – 1. To determine the suitability of a pharmacological protocol for inducing a range of cardiac outputs in anesthetized horses. 2. To determine whether such a protocol could be used in a study comparing the methods of M-mode echocardiography and thermodilution for determination of cardiac output. Animals – Five horses with no evidence of cardiovascular or other systemic disease. Methods – Determinations of cardiac output by M-mode echocardiography were compared with simultaneous ...
BACKGROUND AND OBJECTIVES Dobutamine is an inotropic agent with predominant beta1- adrenergic properties frequently used to increase blood flow in critically ill patients. Dobutamine may have a role in increasing splanchnic perfusion, thereby protecting this area from further injury. We investigated the effects of low doses dobutamine (5 mug/kg/min) on tissue oxygenation, inflammatory response and postoperative complications in high-risk surgical patients. METHODS Prospective, randomized, blin ...
Transcatheter aortic valve implantation (TAVI) with an increasing number of valve types has revolutionized the management of patients with aortic stenosis, particulary of those at higher risk for surgery. Since its introduction, the results of TAVI have improved markedly, and, today, not only patients at high risk, but also those at intermediate risk are considered for the procedure. Paravalvular leakage is an important complication of TAVI that erodes its clinical benefits and the confidence in ...
The role of hypothalamic paraventricular adrenoceptors and angiotensin II (ANG II)-AT 1 receptors in mediating the vasopressin (AVP) release into the plasma in response to i.c.v. and local paraventricular ANG II injections was investigated in conscious chronically instrumented rats. Noradrenaline (NA) administered bilaterally into the paraventricular nucleus (PVN) dose-dependently stimulated AVP release. Bilateral PVN microinjections of the alpha 1 adrenoceptor agonists methoxamine and phenyleph ...
Forty-two consecutive patients received emergency treatment for acute mitral insufficiency causing pulmonary edema between 1984 and 1992. The underlying diagnoses were acute myocardial infarction (n = 21), acute bacterial endocarditis on the native mitral valve (n = 9), prosthetic endocarditis in the mitral position (n = 4), acute failure of a replacement valve (n = 5), blunt chest trauma (n = 1) and chordal rupture in Marfan's syndrome (n = 2). Dysfunction of the subvalvular apparatus was prese ...
In septic shock, the extent to which lactic acidosis (LA) is a consequence of splanchnic lactate overproduction (SLP) or impaired hepatic lactate extraction (HLE) is not clear. We examined SLP and HLE in E. coli sepsis in dogs. We further determined the effects of vasopressor treatments, which included phenylephrine, dopamine, norepinephrine, and a combination of dobutamine and norepinephrine treatment, on SLP and HLE in respective groups. The animals were studied while anesthetized and ventilat ...
OBJECTIVE Corticosteroid replacement improves outcome in adults with relative adrenal insufficiency and catecholamine-resistant septic shock. We evaluated the relationship of absolute and relative adrenal insufficiency to catecholamine-resistant septic shock in children. DESIGN Prospective cohort study. SETTING University hospital pediatric intensive care unit in Brazil. PATIENTS Fifty-seven children with septic shock. Children with HIV infection, those with a history of adrenal insufficie ...
OBJECTIVES The presence of pulmonary artery hypertension (PAH) affects the prognosis of patients; therefore, it is important to treat it. The aim of this study is to compare the acute hemodynamic effects of inhaled nitroglycerine (iNTG), intravenous nitroglycerine (IV NTG) alone and their combination with intravenous dobutamine (IV DOB) during the early postoperative period, in patients with PAH undergoing mitral valve or double valve replacement surgery. MATERIALS AND METHODS In the study, 40 ...
Although a relation between magnitude of ST segment elevation and myocardial damage has been shown in the early period of acute myocardial infarction (AMI), such a relation between the shape of the ST segment elevation, myocardial damage, and the clinical course remains obscure. For this purpose 62 first anterior AMI patients admitted in the first 6 h were enrolled for the study. On the basis of precordial V3 derivation prior to thrombolytic therapy, the shape of the ST elevation was separated i ...
There are no standard criteria for the diagnosis of myocardial ischemia in akinetic segments during dobutamine stress echocardiography (DSE). The aim of the study was to assess the relation between different responses of akinetic segments during DSE and ischemia assessed by thallium-201 single-photon emission computed tomography (SPECT). Dobutamine-atropine stress echocardiography with simultaneous stress-reinjection thallium-201 SPECT was performed in 67 patients with old myocardial infarction ...
AIMS OF THE STUDY To evaluate the incidence of postresuscitation myocardial depression (PRMD) and hemodynamical parameters associated with PRMD in patients treated with therapeutic hypothermia (TH) after out-of-hospital cardiac arrest with ventricular fibrillation (OHCA-VF). METHODS Analysis of hemodynamical data from computerized clinical databases of two academic ICUs during two year period. We analyzed hemodynamical data from a subgroup of patients with pulmonary artery catheter (PAC). We d ...
AIM To perform a meta-analysis and systematic review of published data to assess the relationship between contractile reserve and response to cardiac resynchronization therapy (CRT) in patients with heart failure. METHODS AND RESULTS We searched MEDLINE/PubMed and Cochrane for all papers published up to 26 April 2016, supplemented by manual searches of reference lists from retrieved articles. The search strategy yielded nine observational studies that met our eligibility criteria with a total ...
Sixty-three patients (aged from 4 to 75 years) who had suffered severe head injury or cerebrovascular disease were placed on barbiturate regimens in which intravenous administration was given in amounts of 1-4 mg/kg/hr. Dobutamine and dopamine were also administered to prevent cardiac failure and renal failure. Immediate and delayed complications caused by barbiturate therapy were investigated and analyzed. Immediate complications included tachycardia which was seen in 16 cases (25%), and hypote ...
Changes in mixed venous blood oxygen saturation (SvO2) were studied in 2 groups of patients. Group I patients (n = 10) were all hypoxaemic, suffering from acute respiratory failure, requiring that FIO2 be maintained at 1 throughout the study; respiratory and haemodynamic conditions were improved using PEEP and cardiovascular support. On the other hand, Group II patients (n = 13) were non-hypoxaemic patients with circulatory shock in whom FIO2 was gradually increased, and the haemodynamic status ...
BACKGROUND Exercise stress test and dobutamine stress echocardiography are usually performed early after an uncomplicated acute myocardial infarction in the prognostic stratification of patients to define the optimal diagnostic and therapeutic procedure. The aim of this study was to evaluate if the association of an imaging test could increase exercise test capability to identify patients with residual ischemia and patients at high risk of events in the follow-up. METHODS Four hundred and fort ...
The significance of ST segment elevation in dobutamine stress echocardiography (DSE) remains controversial. In patients with prior Q wave myocardial infarction (MI), it may reflect myocardial ischemia, contractile reserve in the infarct-related area, or dyskinesia of the infarcted areas of myocardium. In the nonpost-MI population, it has been attributed to vasospasm or strongly associated with coronary artery disease and ischemia. We hypothesized that ST segment elevation in the absence of induc ...