Tags

Type your tag names separated by a space and hit enter

Comparison of the effects of urapidil and nitroprusside on hemodynamics and myocardial function in hypertension following cardiac surgery.
Blood Press Suppl. 1994; 4:31-8.BP

Abstract

Hypertension associated with tachycardia, elevated filling pressures and increased systemic vascular resistance occurs in 30-60% of patients recovering from coronary artery surgery (1,2). It is usually present when the patients arrive from the operating room in the intensive care unit (ICU), or develops in the first two hours postoperatively. Traditionally sodium nitroprusside (S) is the drug of first choice for the i.v. treatment and prevention of hypertension and increased filling pressures developing after coronary artery surgery (CAS). Its major disadvantage is reflex tachycardia associated with increased myocardial oxygen consumption. Urapidil (U) has both peripheral alpha-1-adrenoreceptor blocking activity and a central antihypertensive effect at the level of the 5HT-1A serotonergic receptor, resulting in enhanced peripheral sympathetic inhibition (3,4). Informed consent and institutional approval for the study were obtained. When mean arterial blood pressure (MAP) increased above 90 mmHg within the first 2 hours after CAS, 53 patients were randomly allocated to one of two groups. 25 patients received U (bolus of 25 mg; initial infusion rate of 15-85 micrograms/kg/min; maintenance infusion rate of 2-7 micrograms/kg/min) and 28 patients received S (initial infusion rate of 1-2 micrograms/kg/min; maintenance infusion rate of max. 5 micrograms/kg/min). The infusion rate was then adjusted to maintain MAP between 80 and 90. Measuring points were: 1. baseline; 2. 30 min after starting the infusion; 3. 60 min after starting the infusion; and at 2 hour intervals thereafter until the next morning.(

ABSTRACT

TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Van der Stroom JG
Department of Anesthesiology, Academic Medical Center, The Netherlands.
Van Wezel HB
No affiliation info available
Koolen JJ
No affiliation info available
Visser CA
No affiliation info available
Van Zwieten PA
No affiliation info available

MeSH

Antihypertensive AgentsBlood PressureCoronary VesselsEchocardiographyHeartHeart RateHemodynamicsHumansHypertensionMiddle AgedNitroprussidePiperazinesPostoperative Complications

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

7804510

Citation

Van der Stroom, J G., et al. "Comparison of the Effects of Urapidil and Nitroprusside On Hemodynamics and Myocardial Function in Hypertension Following Cardiac Surgery." Blood Pressure. Supplement, vol. 4, 1994, pp. 31-8.
Van der Stroom JG, Van Wezel HB, Koolen JJ, et al. Comparison of the effects of urapidil and nitroprusside on hemodynamics and myocardial function in hypertension following cardiac surgery. Blood Press Suppl. 1994;4:31-8.
Van der Stroom, J. G., Van Wezel, H. B., Koolen, J. J., Visser, C. A., & Van Zwieten, P. A. (1994). Comparison of the effects of urapidil and nitroprusside on hemodynamics and myocardial function in hypertension following cardiac surgery. Blood Pressure. Supplement, 4, 31-8.
Van der Stroom JG, et al. Comparison of the Effects of Urapidil and Nitroprusside On Hemodynamics and Myocardial Function in Hypertension Following Cardiac Surgery. Blood Press Suppl. 1994;4:31-8. PubMed PMID: 7804510.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of the effects of urapidil and nitroprusside on hemodynamics and myocardial function in hypertension following cardiac surgery. AU - Van der Stroom,J G, AU - Van Wezel,H B, AU - Koolen,J J, AU - Visser,C A, AU - Van Zwieten,P A, PY - 1994/1/1/pubmed PY - 1994/1/1/medline PY - 1994/1/1/entrez SP - 31 EP - 8 JF - Blood pressure. Supplement JO - Blood Press Suppl VL - 4 N2 - Hypertension associated with tachycardia, elevated filling pressures and increased systemic vascular resistance occurs in 30-60% of patients recovering from coronary artery surgery (1,2). It is usually present when the patients arrive from the operating room in the intensive care unit (ICU), or develops in the first two hours postoperatively. Traditionally sodium nitroprusside (S) is the drug of first choice for the i.v. treatment and prevention of hypertension and increased filling pressures developing after coronary artery surgery (CAS). Its major disadvantage is reflex tachycardia associated with increased myocardial oxygen consumption. Urapidil (U) has both peripheral alpha-1-adrenoreceptor blocking activity and a central antihypertensive effect at the level of the 5HT-1A serotonergic receptor, resulting in enhanced peripheral sympathetic inhibition (3,4). Informed consent and institutional approval for the study were obtained. When mean arterial blood pressure (MAP) increased above 90 mmHg within the first 2 hours after CAS, 53 patients were randomly allocated to one of two groups. 25 patients received U (bolus of 25 mg; initial infusion rate of 15-85 micrograms/kg/min; maintenance infusion rate of 2-7 micrograms/kg/min) and 28 patients received S (initial infusion rate of 1-2 micrograms/kg/min; maintenance infusion rate of max. 5 micrograms/kg/min). The infusion rate was then adjusted to maintain MAP between 80 and 90. Measuring points were: 1. baseline; 2. 30 min after starting the infusion; 3. 60 min after starting the infusion; and at 2 hour intervals thereafter until the next morning.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0803-8023 UR - https://www.unboundmedicine.com/medline/citation/7804510/Comparison_of_the_effects_of_urapidil_and_nitroprusside_on_hemodynamics_and_myocardial_function_in_hypertension_following_cardiac_surgery_ L2 - https://medlineplus.gov/highbloodpressure.html DB - PRIME DP - Unbound Medicine ER -