ENOXIMONE VERSUS EPINEPHRINE NITROGLYCERIN IN CARDIAC LOW-OUTPUT STATES FOLLOWING VALVE-REPLACEMENT

This prospective, randomized, comparative study was designed to assess the inotropic and vasodilatory effects of the selective phosphosidest erase III inhibitor enoximone compared with standard therapy with epin ephrine/nitroglycerin in patients with refractory low output states fo llowing cardiac valve replacement. Enoximone possesses inotropic and v asodilatory properties and has proven to be of beneficial effect in pa tients suffering from severely impaired myocardial function. Six patie nts in each,group received either enoximone bolus-infusion of 0.5 mg/k g over 10 min followed by an infusion of 5 mu g/kg/min up to 20 mu g/k g/min or epinephrine and nitroglycerin infusion of 0.05 and 0.5 mu g/k g/min, respectively, for 4 hours postoperatively. Hemodynamic effects of enoximone and the combination of epinephrine/nitroglycerin were com pared. Both treatments led to positive inotropy with a simultaneous de crease in filling pressures and vascular resistances. The results indi cate that enoximone in low-output states following cardiac valve repla cement was at least equally effective in comparison with standard ther apy with epinephrine and nitrolycerin.