Angiotensin converting enzyme inhibition has no effect on blood pressure and splanchnic perfusion after cardiac surgery

摘要: Purpose: The purpose of this study was to theeffect the angiotensin-converting enzyme inhibitor, enalaprilat, on blood pressure and splanchnic perfusion after cardiac surgery. Materials Methods: Sixteen patients were studied coronary artery bypass grafting. After admission intensive care unit, a 30-minute baseline measurement systemic hemodynamics, oxygen transport, gastric tonometry performed. In 6 10 receiving enalaprilat in each control patients, regional (splanchnic leg) flows measured also. period, received 0.5 mg bolus thereafter an incremental infusion up total dose (mean 8.3; range 4 mg) continued reduce mean arterial (MAP) 70 80 mm Hg. A period repeated 2 3 hours first period. group, second performed at corresponding time points. barResults: Though MAP decreased group (enalaprilat 99 ± 14 Hg v 89 21 Hg, P = NS) only targeted reduction achieved. No significant changes observed either or flows. Systemic, pulmonary, femoral vascular resistance indices significantly both groups. Gastricarterial Pco difference did not change Angiotensin-converting activity (10.0 2.3 1.3 0.3 U · I −1 , Conclusions: effect poor it had no beneficial effects circulation. Renin-angiotensin activation is major factor hypertension