관상동맥 우회술을 받는 환자에서 Milrinone과 저용량 Vasopressin 정주에 의한 혈역학적 효과

• Published in: Korean journal of anesthesiology Vol. 46; no. 3; pp. 293 - 297
• Main Authors: 전윤석, Yun Seok Jeon, 김대희, Dai Hee Kim, 윤태균, Tae Gyun Yoon, 위상우, Sang Woo We, 윤승준, Seung Joon Yoon, 박재현, Jae Hyun Park, 함병문, Byung Moon Ham
• Format: Journal Article
• Language: Korean
• Published: 대한마취통증의학회 30.03.2004
• Subjects: milrinone; right heart failure; vasopressin; 마취과학
• ISSN: 2005-6419; 2005-7563

Background: AVP (arginine vasopressin) shows unique hemodynamlc characteristics, as a vasopressor. AVP has been tried in many cathecholamlne refractory vasodilatory situations, and sometimes resulted in effective hemodynamic improvement. In this study, we hypothesized that low dose AVP infusion could recover the decreased SVR (systemic vascular resistance) induced by milrinone infusion with minimal effect on PVR (pulmonary vascular resistance). Methods: Sixteen patients undergoing OPCAB participated in this study. After a loading dose milrinone was infused, low dose vasopressin infusion was started and titrated until the systemic blood pressure increased by 20%. During the study, hemodynamic factors including pulmonary capillary wedge pressure and cardiac output were measured using a continuous thermodilution technique with a Swan-Ganz catheter. Results: Milrinone infusion reduced both SVR and PVR. And vasopression infusion increased SVR, but show relatively less effect on PVR. Conclusions: Low-dose vasopressin infision could be used to recover the SVR decrease caused by milirlnone infusion with little effect on PVR (Korean J Anesthesiol 2004; 46: 293∼297)