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Use of low-dose β(1)-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study
BACKGROUND: Sinus tachycardia coupled with high-dose catecholamine is common after cardiopulmonary bypass (CPB). The present study assessed the hemodynamic efficacy and safety of combination therapy using low-dose β(1)-selective adrenergic blocker (landiolol) and inotropes. METHODS: This was a retro...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6659295/ https://www.ncbi.nlm.nih.gov/pubmed/31345252 http://dx.doi.org/10.1186/s13019-019-0966-z |
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author | Sakai, Michihiro Jujo, Satoshi Kobayashi, Junjiro Ohnishi, Yoshihiko Kamei, Masataka |
author_facet | Sakai, Michihiro Jujo, Satoshi Kobayashi, Junjiro Ohnishi, Yoshihiko Kamei, Masataka |
author_sort | Sakai, Michihiro |
collection | PubMed |
description | BACKGROUND: Sinus tachycardia coupled with high-dose catecholamine is common after cardiopulmonary bypass (CPB). The present study assessed the hemodynamic efficacy and safety of combination therapy using low-dose β(1)-selective adrenergic blocker (landiolol) and inotropes. METHODS: This was a retrospective, single center, self-comparison study at post-anesthesia care unit within a tertiary care center. The study included adults who underwent cardiac surgery with CPB and received landiolol between April 2007 and November 2011. We assessed hemodynamic data prior to and 1 h after initiation of landiolol therapy. RESULTS: We evaluated 11 patients who were administered 2.6 ± 1.3 μg/kg/min (mean ± SD) landiolol with sinus tachycardia and received catecholamine therapy after on-pump cardiovascular surgery. Landiolol administration led to a significant reduction in heart rate (HR; 112.4 ± 5.8 vs 126.0 ± 7.6 beats/min, p < 0.001), and a significant increase in stroke volume index (SVI) assessed by pulmonary artery catheterization (22.4 ± 5.4 vs. 18.9 ± 4.2 mL/m(2), p = 0.04). Only one patient showed no HR reduction, whereas seven patients showed decreased HR and increased SVI (64, 95% confidence interval: 30–98%). Moreover, all five patients who received high-dose catecholamine support showed improved hemodynamics. In terms of safety, no patients required cessation of landiolol therapy. CONCLUSIONS: Low-dose landiolol therapy may safely decrease HR and improve hemodynamics among patients with sinus tachycardia receiving catecholamine treatment after cardiovascular surgery. TRIAL REGISTRATION: This study is retrospective. Registration number: 11. Duration of registration: April 2007~November 2011. |
format | Online Article Text |
id | pubmed-6659295 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-66592952019-08-01 Use of low-dose β(1)-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study Sakai, Michihiro Jujo, Satoshi Kobayashi, Junjiro Ohnishi, Yoshihiko Kamei, Masataka J Cardiothorac Surg Research Article BACKGROUND: Sinus tachycardia coupled with high-dose catecholamine is common after cardiopulmonary bypass (CPB). The present study assessed the hemodynamic efficacy and safety of combination therapy using low-dose β(1)-selective adrenergic blocker (landiolol) and inotropes. METHODS: This was a retrospective, single center, self-comparison study at post-anesthesia care unit within a tertiary care center. The study included adults who underwent cardiac surgery with CPB and received landiolol between April 2007 and November 2011. We assessed hemodynamic data prior to and 1 h after initiation of landiolol therapy. RESULTS: We evaluated 11 patients who were administered 2.6 ± 1.3 μg/kg/min (mean ± SD) landiolol with sinus tachycardia and received catecholamine therapy after on-pump cardiovascular surgery. Landiolol administration led to a significant reduction in heart rate (HR; 112.4 ± 5.8 vs 126.0 ± 7.6 beats/min, p < 0.001), and a significant increase in stroke volume index (SVI) assessed by pulmonary artery catheterization (22.4 ± 5.4 vs. 18.9 ± 4.2 mL/m(2), p = 0.04). Only one patient showed no HR reduction, whereas seven patients showed decreased HR and increased SVI (64, 95% confidence interval: 30–98%). Moreover, all five patients who received high-dose catecholamine support showed improved hemodynamics. In terms of safety, no patients required cessation of landiolol therapy. CONCLUSIONS: Low-dose landiolol therapy may safely decrease HR and improve hemodynamics among patients with sinus tachycardia receiving catecholamine treatment after cardiovascular surgery. TRIAL REGISTRATION: This study is retrospective. Registration number: 11. Duration of registration: April 2007~November 2011. BioMed Central 2019-07-25 /pmc/articles/PMC6659295/ /pubmed/31345252 http://dx.doi.org/10.1186/s13019-019-0966-z Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Sakai, Michihiro Jujo, Satoshi Kobayashi, Junjiro Ohnishi, Yoshihiko Kamei, Masataka Use of low-dose β(1)-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study |
title | Use of low-dose β(1)-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study |
title_full | Use of low-dose β(1)-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study |
title_fullStr | Use of low-dose β(1)-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study |
title_full_unstemmed | Use of low-dose β(1)-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study |
title_short | Use of low-dose β(1)-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study |
title_sort | use of low-dose β(1)-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6659295/ https://www.ncbi.nlm.nih.gov/pubmed/31345252 http://dx.doi.org/10.1186/s13019-019-0966-z |
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