기본 콘텐츠로 건너뛰기

[CK] Digoxin and Dobutamine combination

Hemodynamic effects of combined digoxin and dopamine administration in postoperative patients with cardiac dysfunction☆

Abstract

In 10 patients with postoperative cardiac dysfunction which required dopamine for inotropic and hemodynamic support, we observed the cardiovascular effects of short-term digoxin administration. The average dosage of dopamine was 7.45 μg/kg per minute and was maintained while the patients were given 1 mg of digoxin over 8 hours. The dosage of dopamine was then tapered over the next 4 hours. We observed a significant increase in the cardiac index (4 hours) and a reduction in the heart rate (8 hours) before the dopamine dosage was reduced. After a reduction in dopamine dosage to 2.28 μg/kg per minute, these effects persisted. No significant changes were noted in systemic vascular resistance or pulmonary artery diastolic pressure during digoxin administration. These results indicate that the inotropic effects of dopamine and digoxin are additive when given in combination and that digoxin can be used to significantly reduce the dopamine dosage in patients with postoperative cardiac failure. Thus, the combination of an acute inotropic agent, dopamine, and a chronic inotropic agent, digoxin, appears to be clinically useful in postoperative cardiac dysfunction.

댓글

댓글 쓰기

이 블로그의 인기 게시물

[CK] STEMI_EKG learning.

892 × 548 저작권 보호를 받는 이미지일 수 있습니다.    자세히 알아보기 ECG - Common STEMI Mimics | Grays Integrative Physiology Grays Integrative Physiology Mimics will not produce reciprocal changes. If RCs in related leads, should consider it a STEMI. 방문 추가 컬렉션 공유
댓글 쓰기
자세한 내용 보기

[CK] LVAD parameter review. [ ] tree !!

Vital(BP): hypo, hyper. PEx(JVP): volume status -------------------------------- 1st. PI(3-7)= contractility and volume status(high volume only cause high PI) overload = high PI. low volume = low PI. (=low volume = low preload = RV failure, arrhythmia same thing) HTN = low PI low BP = low PI. (only overload cause high PI = with high preload, but otherwise, BP, volume => cause low PI) 2nd. Flow(4-6) overload, 3rd. Power(surge = only thrombus, 4-6) hypotension route (BP) => high VADFL = vasodilator, sepsis = R/O => low VADFL(most common)  with high JVP => RV failure, PE/tamponade, pneumothorax                                                                               , then adjust LVAD(higher)                ...
댓글 쓰기
자세한 내용 보기

EGD, endoscopy, Colonoscopy prep.

EGD:  8hr = clear liquid diet(technically up to 2 hour, but preferred 4 hours prior to procedure)  4hr = medication with water  2hr = strict npo(nothing) Colonoscopy  8hr = no food at all but water is ok.  2hr = no liquid neither   Patients typically take no food by mouth for four to eight hours prior to the procedure (sometimes longer if there is known or suspected delayed gastric emptying) and no liquids (other than sips with medications) for two hours   Enteroscopy   Patients should fast after midnight the evening prior to the examination to allow time for food residue to clear the small bowel. In addition, patients undergoing retrograde examinations should receive a bowel preparation to cleanse the colon. cf) ASA- sedation protocol(procedure)     The American Society for Anesthesiology (ASA) guidelines state that prior to a procedure, patients should fast a minimum of two hours following clear liquid ingestion or six ...
댓글 쓰기
자세한 내용 보기