Use of low-dose β1-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study
Abstract Background Sinus tachycardia coupled with high-dose catecholamine is common after cardiopulmonary bypass (CPB). The present study assessed the hemodynamic efficacy and safety of combination therapy using low-dose β1-selective adrenergic blocker (landiolol) and inotropes. Methods This was a...
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| Format: | Article |
| Language: | English |
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BMC
2019-07-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | http://link.springer.com/article/10.1186/s13019-019-0966-z |
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| author | Michihiro Sakai Satoshi Jujo Junjiro Kobayashi Yoshihiko Ohnishi Masataka Kamei |
| author_facet | Michihiro Sakai Satoshi Jujo Junjiro Kobayashi Yoshihiko Ohnishi Masataka Kamei |
| author_sort | Michihiro Sakai |
| collection | DOAJ |
| description | Abstract Background Sinus tachycardia coupled with high-dose catecholamine is common after cardiopulmonary bypass (CPB). The present study assessed the hemodynamic efficacy and safety of combination therapy using low-dose β1-selective adrenergic blocker (landiolol) and inotropes. Methods This was a retrospective, single center, self-comparison study at post-anesthesia care unit within a tertiary care center. The study included adults who underwent cardiac surgery with CPB and received landiolol between April 2007 and November 2011. We assessed hemodynamic data prior to and 1 h after initiation of landiolol therapy. Results We evaluated 11 patients who were administered 2.6 ± 1.3 μg/kg/min (mean ± SD) landiolol with sinus tachycardia and received catecholamine therapy after on-pump cardiovascular surgery. Landiolol administration led to a significant reduction in heart rate (HR; 112.4 ± 5.8 vs 126.0 ± 7.6 beats/min, p < 0.001), and a significant increase in stroke volume index (SVI) assessed by pulmonary artery catheterization (22.4 ± 5.4 vs. 18.9 ± 4.2 mL/m2, p = 0.04). Only one patient showed no HR reduction, whereas seven patients showed decreased HR and increased SVI (64, 95% confidence interval: 30–98%). Moreover, all five patients who received high-dose catecholamine support showed improved hemodynamics. In terms of safety, no patients required cessation of landiolol therapy. Conclusions Low-dose landiolol therapy may safely decrease HR and improve hemodynamics among patients with sinus tachycardia receiving catecholamine treatment after cardiovascular surgery. Trial registration This study is retrospective. Registration number: 11. Duration of registration: April 2007~November 2011. |
| first_indexed | 2024-12-10T23:32:07Z |
| format | Article |
| id | doaj.art-c92ca83f48684a9e8c0d7669883915b0 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-12-10T23:32:07Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-c92ca83f48684a9e8c0d7669883915b02022-12-22T01:29:21ZengBMCJournal of Cardiothoracic Surgery1749-80902019-07-011411610.1186/s13019-019-0966-zUse of low-dose β1-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective studyMichihiro Sakai0Satoshi Jujo1Junjiro Kobayashi2Yoshihiko Ohnishi3Masataka Kamei4Department of Clinical Anesthesiology, Mie University HospitalDepartment of Anesthesiology, National Cerebral and Cardiovascular CenterDepartment of Cardiovascular Surgery, National Cerebral and Cardiovascular CenterDepartment of Anesthesiology, National Cerebral and Cardiovascular CenterDepartment of Clinical Anesthesiology, Mie University HospitalAbstract Background Sinus tachycardia coupled with high-dose catecholamine is common after cardiopulmonary bypass (CPB). The present study assessed the hemodynamic efficacy and safety of combination therapy using low-dose β1-selective adrenergic blocker (landiolol) and inotropes. Methods This was a retrospective, single center, self-comparison study at post-anesthesia care unit within a tertiary care center. The study included adults who underwent cardiac surgery with CPB and received landiolol between April 2007 and November 2011. We assessed hemodynamic data prior to and 1 h after initiation of landiolol therapy. Results We evaluated 11 patients who were administered 2.6 ± 1.3 μg/kg/min (mean ± SD) landiolol with sinus tachycardia and received catecholamine therapy after on-pump cardiovascular surgery. Landiolol administration led to a significant reduction in heart rate (HR; 112.4 ± 5.8 vs 126.0 ± 7.6 beats/min, p < 0.001), and a significant increase in stroke volume index (SVI) assessed by pulmonary artery catheterization (22.4 ± 5.4 vs. 18.9 ± 4.2 mL/m2, p = 0.04). Only one patient showed no HR reduction, whereas seven patients showed decreased HR and increased SVI (64, 95% confidence interval: 30–98%). Moreover, all five patients who received high-dose catecholamine support showed improved hemodynamics. In terms of safety, no patients required cessation of landiolol therapy. Conclusions Low-dose landiolol therapy may safely decrease HR and improve hemodynamics among patients with sinus tachycardia receiving catecholamine treatment after cardiovascular surgery. Trial registration This study is retrospective. Registration number: 11. Duration of registration: April 2007~November 2011.http://link.springer.com/article/10.1186/s13019-019-0966-zTachycardiaCatecholamineCardiovascular surgery |
| spellingShingle | Michihiro Sakai Satoshi Jujo Junjiro Kobayashi Yoshihiko Ohnishi Masataka Kamei Use of low-dose β1-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study Journal of Cardiothoracic Surgery Tachycardia Catecholamine Cardiovascular surgery |
| title | Use of low-dose β1-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study |
| title_full | Use of low-dose β1-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study |
| title_fullStr | Use of low-dose β1-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study |
| title_full_unstemmed | Use of low-dose β1-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study |
| title_short | Use of low-dose β1-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study |
| title_sort | use of low dose β1 blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery a retrospective study |
| topic | Tachycardia Catecholamine Cardiovascular surgery |
| url | http://link.springer.com/article/10.1186/s13019-019-0966-z |
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