HEMODYNAMIC ADVANTAGES OF LEFT ATRIAL EPINEPHRINE ADMINISTRATION IN OPEN-HEART OPERATIONS

Background. It is often necessary to administer a catecholamine to pat ients who have undergone cardiac operations. However, there are some p otential disadvantages to using the central venous circulation, a rout ine route for catecholamine infusion. The advantages of the left atria l infusion of epinephrine were investigated in 21 patients. Methods. T he first group received epinephrine through the central venous route ( central venous group), and the second group received adrenaline throug h the left atrial route (left atrial group). Hemodynamic studies were performed in all patients before and after the infusions. Blood sample s were also taken from the radial and pulmonary arteries to determine the epinephrine concentrations. Results. The average pulmonary arteria l pressure and pulmonary vascular resistance were higher in the centra l venous group, whereas higher cardiac indices and average blood press ures were noted in the left atrial group (p < 0.05). There was a stati stically significant difference in the epinephrine concentrations in t he pulmonary arterial and radial arterial samples between the two grou ps. Conclusions. We conclude that epinephrine infusion through the lef t atrial route is associated with greater hemodynamic advantages than infusion through the central venous route. (C) 1997 by The Society of Thoracic Surgeons.