Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effect of the new positive inotropic and vasodilatator bipyridine-derivate Amrinon on catecholamine-refractive heart insufficiency in septic shock is described. A bolus dose of 1 mg/kg b.w., followed by continuous infusion of Amrinon 10 micrograms/kg b.w./min improved the haemodynamic parameters of all seven patients. The severe tachycardia before therapy was diminished more than 30%, the blood-pressure increased about 25-30%. RAP, PAP and PCWP showed a diminution of 35-45%. The cardiac output increased nearly 100% under therapy. All patients had IPPV with high inspiratory oxygen concentration, with inversed-ratio-ventilation and high positive end-expiratory pressure. Under Amrinon-therapy the initial pulmonary insufficiency diminished. The oliguria/anuria existing before Amrinon-therapy was improved also. Amrinon was given over 24-36 hours, the total dose was between 800 and 1440 mg. Six of the seven patients survived their severe illness; one patient died of pulmonary embolism, confirmed by autopsy, four weeks after Amrinon-therapy.
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PMID:[Amrinone in catecholamine refractory heart failure in septic shock]. 409 58

Left ventricular end diastolic (LVEDP) and mean right atrial (RAP) pressures were recorded simultaneously in 30 patients with shock (14 acute myocardial infarction, 10 acute pulmonary embolism or severe bronchopulmonary disease, and 6 sepsis). Myocardial infarction was characterized by a predominant increase in LVEDP, pulmonary disease by a predominant increase in RAP, and sepsis by a normal relationship between LVEDP and RAP. In all three groups a significant positive correlation was noted between RAP and LVEDP, with the regression line in cor pulmonale deviated significantly toward the RAP axis and the regression line in myocardial infarction exhibiting a zero RAP intercept at an elevated LVEDP.Low cardiac outputs with elevated LVEDP in myocardial infarction indicated severe left ventricular failure. Low outputs with elevated RAP in cor pulmonale were consistent with right ventricular overload. Although cardiac outputs often were normal in sepsis, low outputs with elevated cardiac filling pressures in some patients were consistent with a hemodynamic or humoral-induced generalized depression of cardiac performance.Vasoconstrictor and inotropic drugs often produced a functional disparity between the two ventricles, with the gradient between LVEDP and RAP increasing, apparently because of an increase in left ventricular work or an inadequacy of left ventricular oxygen delivery. Acute plasma volume expansion with dextran in patients with pulmonary vascular disease resulted in a somewhat more rapid rise in RAP than in LVEDP. In septic and myocardial infarction shock, however, LVEDP and RAP usually rose proportionally, with the absolute rise of LVEDP surpassing that of RAP. Although the absolute level of the central venous pressure thus may not be a reliable indicator of left ventricular function in shock, changes in venous pressure during acute plasma volume expansion should serve as a fairly safe guide to changes in LVEDP.
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PMID:Studies in clinical shock and hypotension: VI. Relationship between left and right ventricular function. 1669 56