Key result
High-dose esmolol during MIDCAB surgery decreased mean cardiac output and mean arterial pressure (53 vs 89 mmHg) compared to pre-esmolol baseline.
Why the study?
Does high-dose esmolol affect haemodynamics and oxygen extraction in patients undergoing MIDCAB surgery?
Does high-dose esmolol affect haemodynamics and oxygen extraction in patients undergoing MIDCAB surgery?
High-dose esmolol during MIDCAB surgery safely reduces cardiac output and mean arterial pressure, suggesting a favorable reduction in myocardial oxygen consumption.
Answers are grounded in this paper and cite their sources.
May lower myocardial oxygen demand during MIDCAB; hypothesis-generating and should not change practice without randomized confirmation.
UNLABELLED: We aimed to investigate the effects of high-dose esmolol on haemodynamics and oxygen extraction in minimally invasive direct coronary artery bypass (MIDCAB) surgery patients. METHODS: In 18 patients, heart rate (HR), mean arterial (MAP), central venous (CVP), pulmonary capillary wedge pressure (PCWP), cardiac output (CO), and mixed venous oxygen saturation (Sv0(2)) were prospectively measured after induction of anaesthesia (T1), start of surgery (T2), during bypass grafting with beta-blockade (T3), and at the end of surgery (T4). RESULTS: Mean esmolol dose at T3 was 0.44+/-0.2mgkg(-1)min(-1). HR was unchanged, whereas significant decreases in mean CO (3.1+/-0. 8 vs 4.8+/-1.0lmin(-1)m(-2), pre-esmolol), MAP (53+/-10 vs 89+/-14mmHg), and SvO(2) (65+/-10 vs 81+/-4%) were observed during esmolol administration. All haemodynamic parameters normalized immediately after termination of esmolol (T4). CONCLUSIONS: Despite unchanged HR esmolol reduced CO and MAP suggesting a favorable reduction of myocardial oxygen consumption. Mean Sv0(2) during esmolol administration reflects an acceptable ratio of whole-body oxygen delivery and consumption. Haemodynamic changes with high-dose esmolol during MIDCAB surgery remain within safety margins.
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Ivan Aleksić (2000) studied Minimally invasive direct coronary artery bypass (MIDCAB) surgery (n=18). High-dose esmolol vs. Pre-esmolol baseline was evaluated on Haemodynamic changes including cardiac output, mean arterial pressure, and mixed venous oxygen saturation. High-dose esmolol during MIDCAB surgery decreased mean cardiac output and mean arterial pressure (53 vs 89 mmHg) compared to pre-esmolol baseline.
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