Effect of Pressor Amines on Cardiac Output in Patients with Acute Hypotension

Sambhi, Mohinder P.; Weil, Max Harry; Udhoji, Vasant N.; Rosoff, Leonard

doi:10.1161/01.cir.30.4.485

Cited by 19 publications

(23 citation statements)

References 20 publications

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“…and usually C.O. in patients with hypolension because of myocardial infarction (18,22) and also in a mixed material of 19 patients with hypotension (1 drug poisoning) and in whom infectious diseases dominated (31). In these materials there was a significant increase in peripheral vascular resistance contrasting with the findings in the present study.…”

Section: Discussioncontrasting

confidence: 94%

Hemodynamic Effects of Norepinephrine in Severe Hypnotic Drug Poisoning With Arterial Hypotension

Hulting

Thorstrand

1972

Journal of Internal Medicine

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The hemodynamic response to infusion of norepinephrine (NE) has been measured in 12 patients with severe hypnotic drug poisoning. All patients had a mean arterial blood pressure (B.P.) of 70 mmHg or less initially. As evaluated from central venous pressure no marked hypovolemia was present. Cardiac output (C.O.) was determined by the dye dilution method and right heart catheterization by a “floating” catheter technique. Following infusion of NE the arterial B.P. and C.O. increased. The increase in C.O. resulted from increases in stroke volume and to a less extent also in heart rate (HR). There was no significant change of peripheral vascular resistance index (PVRI), in contrast to the NE effect in cardiogenic, hemorrhagic and septic shock states. The increase in arterial B.P. was accompanied by an increase in HR, which implies a disturbed function of the high pressure baroreceptor system. The rise in B.P. is primarily due to the increase in C.O. No adverse effects were noted during the NE infusion. It is concluded that NE is beneficial in the treatment of severe hypnotic drug poisoning complicated by hypotension.

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Section: Discussioncontrasting

confidence: 94%

Hemodynamic Effects of Norepinephrine in Severe Hypnotic Drug Poisoning With Arterial Hypotension

Hulting

Thorstrand

1972

Journal of Internal Medicine

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“…Hospital mortality was reported in three studies and ranged between 33–75% for those treated with metaraminol compared to 44–83% for those treated with noradrenaline (Table 1). 24–26 Overall, there was no difference in hospital mortality between metaraminol and noradrenaline groups (Table 1). Furthermore, there was no difference in the effect on haemodynamics (MAP or SBP) between metaraminol and noradrenaline groups (Table 1).…”

Section: Resultsmentioning

confidence: 96%

“…The PRISMA flow diagram for study selection is outlined in Figure 1. After assessment for eligibility against study selection criteria, a total of four out of 1387 eligible studies were included 23–26 …”

Section: Resultsmentioning

confidence: 99%

“…The characteristics of included studies are detailed in Table 1 23–26 . These included three prospective observational studies conducted between 1964‐1965 in the United States, 24–26 and one non‐randomised controlled single‐arm crossover trial conducted in 2005 in Italy 23 . The studies involved a total of 54 adult patients, with sample sizes ranging between 10 to 19 patients.…”

Section: Resultsmentioning

confidence: 99%

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Efficacy and safety of metaraminol in critically ill patients with shock: a systematic review

Sardaneh

Narayan

Penm

et al. 2022

Pharmacy Practice and Res

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Aim: To assess the efficacy and safety of metaraminol infusions in comparison to other vasopressors in critically ill patients with shock with regard to hospital mortality, effect on haemodynamics (mean arterial pressure or systolic blood pressure), duration of vasopressor use, and adverse events. Data sources: A systematic review was conducted in eight electronic databases and nine trial registers from inception to 17 March 2021. Study selection: Studies included randomised or non-randomised controlled trials, and retrospective or prospective observational studies of critically ill adult patients admitted to the intensive care unit or emergency department with shock of any aetiology and who received metaraminol via continuous infusion compared to patients who received other vasopressors. Results: Out of 1387 eligible articles, three observational studies and one controlled trial were included involving a total of 54 patients. Study patients had different types of shock including septic (n = 28), cardiogenic (n = 21), hypovolemic (n = 3) and neurogenic shock (n = 2). All studies compared metaraminol to noradrenaline and were of poor quality and high risk of bias. There was no difference in hospital mortality or effect on mean arterial pressure or systolic blood pressure between metaraminol and noradrenaline in any of the studies. None of the studies reported the duration of vasopressor use or adverse drug events such as extravasation or tissue injury. Conclusion: There is limited and low-quality efficacy and safety data to support the use of metaraminol over other vasopressors in critically ill patients with shock. Future clinical trials are needed before this agent is routinely used in this patient population.

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“…Because acidosis de presses cardiac contractility [5,7] and modifies the actions of various drugs in shock [2,19]; all patients were given 20 mEq of sodium bi carbonate (20 ml of 8.4-percent solution) i.v. on admission.…”

Section: Therapymentioning

confidence: 99%

Clinical Appraisal of Shock Following Acute Myocardial Infarction

Mir¹,

Rees²,

Yahya³

et al. 1974

Cardiology

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An attempt has been made to define clinically recognizable forms of cardiogenic shock. ‘Vasoreactive’ shock, characterized by a cold and sweaty skin, oliguria and moderate to gross mental dysfunction, was managed by reducing the vascular resistance with phenoxybenzamine. ‘Vasolytic’ shock, suggested by a grey or flushed facies, slightly reduced urinary output, and mild to moderate mental impairment, was treated with aramine. Patients with clinical features between these two extremes (‘intermediate’ group) were initially treated according to the most prominent clinical features. Further management was based on the assessment of easily measurable parameters such as central venous pressure, acid-base status, arterial pressure, temperature, etc. The mortality rate of the entire group of 31 patients was 42%.

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Effect of Pressor Amines on Cardiac Output in Patients with Acute Hypotension

Cited by 19 publications

References 20 publications

Hemodynamic Effects of Norepinephrine in Severe Hypnotic Drug Poisoning With Arterial Hypotension

Hemodynamic Effects of Norepinephrine in Severe Hypnotic Drug Poisoning With Arterial Hypotension

Efficacy and safety of metaraminol in critically ill patients with shock: a systematic review

Clinical Appraisal of Shock Following Acute Myocardial Infarction

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