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Hemodynamic effects of sodium nitroprusside in infants and children with congenital heart disease Ken Ueda 1 1Department of Pediatric Cardiology, Shizuoka Children's Hospital pp.333-338
Published Date 1985/3/15
DOI https://doi.org/10.11477/mf.1404204623
  • Abstract
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The hemodynamic effects of sodium nitroprusside (SNP) were studied in 39 infants and children with congenital heart disease. They were divided into three groups acoording to their anatomic lesions ; 8 of isolated mitral regurgitation (MR), 19 of ventricular septal defect (VSD), 12 of patent ducats arteriosus (PDA). VSD and PDA were divided into two subgroups according to the association of pulmonary hypertension (PH). Before and after 4 minutes of administration of SNP at 3μg/kg/min, aortic, pulmonary artery, left atrial and right atrial pressures and saturations were measured.

In MR, forward cardiac output increased from 23.5±7.2 ml to 31.0±8.2 ml (mean±SD, p<0.001) and cardiac index 2.56±0.34 1/min/m2 to 4.08±0.57 1/min/m2 (p<0.001) as a consequence of a marked decrease in systemic vascular resistance (31.9±2.3 U・m2 to 17.4±4.1 U・m2, p<0.001). In VSD without PH and VSD with PH, left atrial pressure decreased from 8.6±2.3 mmHg to 5.2±1.5 mmHg (p<0.05) and 11.8±1.7 mmHg to 8.1+1.3 mmHg (p<0.001), respectively. Right atrial pres-sure also decreased from 4.3±2.1 mmHg to 2.0±1.2 mmHg (p<0.01) and 6.1±1.5 mmHg to 3.3±1.4 mmHg (p<0.001), respectively. In spite of these reduction of preload, the pulmonary and systemic flow did not decrease significantly. These data show that the systemic blood flow can be maintained at the lower left atrial pressure induced by administra-tion of SNP.

Although limited to the acute setting, it is suggested that SNP may be beneficial in the management of infants and children with VSD as well as MR.


Copyright © 1985, Igaku-Shoin Ltd. All rights reserved.

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