Inotropes in the hypoplastic left heart syndrome: Effects in an animal model

摘要: Background. Despite substantial changes in the surgical treatment of children born with hypoplastic left heart syndrome, overall mortality remains high. Although further improvements outcomes appear to depend on more effective perioperative care, few experimental data exist guide appropriate pharmacologic therapy these infants. Because different inotropic agents may have effects ratio pulmonary systemic flow (Q p /Q s ), we hypothesize that they not be equally at increasing oxygen delivery. Methods. In neonatal piglets (n = 6; 3.5 6.5 kg), placed an innominate artery-to-pulmonary artery shunt, created atrial septal defect, and then occluded right ventricular outflow. We examined a number commonly used agents, administering high low concentrations dopamine (5 15 μg · kg −1 min dobutamine epinephrine (0.05 0.1 μg/min). Results. Dobutamine increased Q from 1.03 ± 0.6 baseline 2.52 0.55 ( decreased 1.23 0.21 0.82 0.08 delivery, were statistically significant. Conclusions. Dopamine, dobutamine, all cardiac output but had substantially possibly due differential vascular resistances. This suggests beneficial clinical setting. Systemic venous saturation arteriovenous difference help determine if given inotrope improves