Why the study?
Does an automated closed-loop dual pump system using glyceryl trinitrate and sodium nitroprusside effectively control arterial pressure in patients requiring vasodilators after cardiopulmonary bypass?
Does an automated closed-loop dual pump system using glyceryl trinitrate and sodium nitroprusside effectively control arterial pressure in patients requiring vasodilators after cardiopulmonary bypass?
An automated closed-loop system successfully controlled post-cardiac surgery hypertension using glyceryl trinitrate, with sodium nitroprusside supplementation required in a minority of patients.
Small case series suggests closed-loop GTN feasibility post-CPB; leaves open need for RCTs to confirm safety and efficacy.
Arterial hypertension after cardiac surgery is common and is associated with increased morbidity. Glyceryl trinitrate may be a more suitable agent for control of hypertension than sodium nitroprusside. We have developed a closed-loop system for the Atari 1040ST microcomputer to control arterial pressure by the simultaneous infusion of two vasodilators under computer control. Use of this system with glyceryl trinitrate and sodium nitroprusside in 24 patients who required vasodilators after cardiopulmonary bypass, revealed that hypertension was controlled by glyceryl trinitrate alone in 14 of the patients and 10 required supplementary sodium nitroprusside. The results suggest that glyceryl trinitrate is a suitable agent for control of hypertension after cardiac surgery in the majority of patients. They also show that a sizeable minority required additional sodium nitroprusside, and that an automated 'dual pump' system is a satisfactory method of administering two vasodilators in this way.
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Colvin et al. (1989) studied this question.
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