| Japanese |
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| Title | 心臓外科手術患者の肺高血圧に対するミルリノン持続静注の効果 |
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| Subtitle | 原著 |
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| Authors | 安部和夫*, 岡淳子**, 船津俊宏***, 竹内麦穂***, 福田宏嗣***, 藤井謙司**** |
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| Authors(kana) | |
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| Organization | *桜橋渡辺病院麻酔科, **大阪中央病院麻酔科, ***桜橋渡辺病院心臓血管外科, ****桜橋渡辺病院循環器内科 |
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| Journal | 循環制御 |
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| Volume | 25 |
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| Number | 4 |
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| Page | 378-381 |
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| Year/Month | 2004/12 |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 全身麻酔導入後に肺高血圧症(平均肺動脈圧30mmHg以上)を呈した心臓外科手術20症例について, ミルリノン0.5μg/kg/分を持続静注し, その薬剤の循環動態に与える影響を検討した. 20症例のうち6症例は投与開始後に収縮期血圧が30%以上低下したので投与を中止し, 残りの14症例でデータを収集した. ミルリノン開始前平均血圧は76±13mmHgから開始後30分で67±11mmHgと有意に低下した. 心拍数は開始前79±23rpmであったのが開始後30分で98±20rpmと有意に増加した. 心拍出量は開始前3.4±1.4L/分だったが30分で4.9±2.6L/分と有意に増加した. 混合静脈血酸素飽和度は開始前69±14%だったのが15分で74±13%と有意に上昇した. 平均肺動脈圧はミルリノン開始前34±12mmHgだったのが開始後30分で29±11mmHgと低下傾向を示し, 開始後30分では23±3mmHgと有意に低下した. 肺血管抵抗は開始前440±112dyne/sec/cm-5から開始後30分で194±56dyne/sec/cm-5と有意に低下した. 以上より, ミルリノンは心臓手術中の肺高血圧に有用であるが, 体血圧の低下に注意が必要であることが示唆された. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | 肺高血圧, 心臓手術, ミルリノン |
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| English |
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| Title | Milrinone Improves Pulmonary Hemodynamics in Patients with Pulmonary Hypertension during Cardiac Surgery |
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| Authors | Kazuo Abe*, Junko Oka**, Hirotoshi Funatsu***, Mugiho Takeuchi***, Hirotsugu Fukuda***, Kenshi Fujii**** |
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| Authors(kana) | |
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| Organization | *Department of Anesthesiology, Sakurabashi Watanabe Hospital, **Department of Anesthesiology, Osaka Central Hospital, ***Department of Cardiovascular Surgery, Sakurabashi Watanabe Hospital, ****Department of Cardiology, Sakurabashi Watanabe Hospital |
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| Journal | Circulation Control |
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| Volume | 25 |
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| Number | 4 |
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| Page | 378-381 |
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| Year/Month | 2004/12 |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | To evaluate the effects of milrinone on the pulmonary hypertension during cardiac surgery, 20 patients who showed pulmonary hypertension after anesthesia induction were studied. Pulmonary artery pressure (PAP), pulmonary vascular resistance (PVR) and hemodynamic parameters were measured before the milrinone infusion (0.5μg/kg/min), and 15min and 30min after the milrinone infusion. Six out of 20 patients were excluded because of decreases in systemic systolic blood pressure by more than 30%. In the other 14 patients, mean artery pressure (from 76±13 to 67±11mmHg), PAP (from 34±12 to 23±3mmHg), central venous pressure (from 12±5 to 8±6mmHg), and PVR (from 440±112 to 194±56dyne/sec/cm -5) decreased significantly at 30 min after the milrinone infusion. Heart rate (from 79±23 to 98±20rate/min), cardiac output (from 3.4±1.6 to 4.9±2.6L/min) increased significantly at 30min after milrinone infusion. Oxygen saturation of mixed venous admixtures increased significantly at 15min after infusion (from 69±14 to 74±11%). These data suggest that milrinone may be a useful drug for the treatment of pulmonary hypertension during cardiac surgery. |
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| Practice | Basic medicine |
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| Keywords | pulmonary hypertension, cardiac surgery, milrinone |
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