What is the clinical evidence from this study?

Study design: Other. Population: End-stage biventricular heart failure (n=39). Intervention: Adenosine infusion vs. Sodium nitroprusside. Primary outcome: Percentage fall in transpulmonary pressure gradient (p=<0.02).

September 1, 1992CirculationOpen Access

Adenosine infusion for the reversal of pulmonary vasoconstriction in biventricular failure. A good test but a poor therapy.

Q: What are the key findings of this study?

Adenosine infusion achieved a similar fall in pulmonary vascular resistance as sodium nitroprusside but a greater fall in transpulmonary pressure gradient (35% vs 9%, p<0.02) in biventricular failure.

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Key result

Adenosine infusion achieved a similar fall in pulmonary vascular resistance as sodium nitroprusside but a greater fall in transpulmonary pressure gradient (35% vs 9%, p<0.02) in biventricular failure.

Why the study?

Does adenosine infusion improve pulmonary hemodynamics compared to sodium nitroprusside in patients with end-stage biventricular heart failure?

Population

Patients with end-stage biventricular heart failure referred for orthotopic heart transplantation.

Comparison

Adenosine infusion with 30% oxygen via face mask. vs Sodium nitroprusside infusion with 30% oxygen…

Design

Cohort

Authors

GHGuy A. HaywoodUniversity Hospitals Plymouth NHS Trust JSJames F. SneddonEast Surrey Hospital YBYaver BashirJohn Radcliffe Hospital

Discussion

Member takes

Implication

Adenosine may aid acute testing of pulmonary vasoreactivity in biventricular failure; leaves open its comparative role versus nitroprusside in prospective studies.

Structured PICO

Does adenosine infusion improve pulmonary hemodynamics compared to sodium nitroprusside in patients with end-stage biventricular heart failure?

Population

Patients with end-stage biventricular heart failure referred for orthotopic heart transplantation (n=21 for adenosine, n=18 for nitroprusside).

Intervention

Adenosine infusion (two doses, including 100 micrograms/kg min) with 30% oxygen via face mask.

Comparator

Sodium nitroprusside infusion with 30% oxygen via face mask.

Outcome

Pulmonary and renal hemodynamic effects (including pulmonary vascular resistance, transpulmonary pressure gradient, mean arterial blood pressure, cardiac index, pulmonary capillary wedge pressure, and renal blood flow).surrogate

Main Result

Absolute Event Rate: 35% vs 9%

p-value: p=<0.02

Adenosine is a potent selective pulmonary vasodilator useful for testing reversibility of pulmonary vasoconstriction in biventricular heart failure, but its tendency to increase left atrial pressure makes it unsuitable for chronic therapy.

Cite This Study

Haywood et al. (1992) studied End-stage biventricular heart failure (n=39). Adenosine infusion vs. Sodium nitroprusside was evaluated on Percentage fall in transpulmonary pressure gradient (p=<0.02). Adenosine infusion achieved a similar fall in pulmonary vascular resistance as sodium nitroprusside but a greater fall in transpulmonary pressure gradient (35% vs 9%, p<0.02) in biventricular failure.

synapsesocial.com/papers/6a0ea5eb06ecbe833447a731 https://doi.org/10.1161/01.cir.86.3.896

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Implication

Adenosine may aid acute testing of pulmonary vasoreactivity in biventricular failure; leaves open its comparative role versus nitroprusside in prospective studies.

Adenosine infusion for the reversal of pulmonary vasoconstriction in biventricular failure. A good test but a poor therapy.

Discussion

Member takes

Implication

Structured PICO

Main Result

Cite This Study

Adenosine infusion for the reversal of pulmonary vasoconstriction in biventricular failure. A good test but a poor therapy.

Discussion

Member takes

Implication

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider