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- March 18, 2011, 10:44:14 AMSodium nitroprusside, dopamine, dobutamine combined treatment of congestive heart failure
With digitalis preparations, Lee feces agents can not be corrected by the general vasodilators by sodium nitroprusside,You are not allowed to view links. Register or Login, dopamine, dobutamine infusion combined with satisfactory effect, reported as follows. General information 1 ll clinical data in 42 cases,You are not allowed to view links. Register or Login, male 25 down, female l7, age plus one 7o years old, average age s5; cardiac function by NHYA grade: Ⅳ grade cases, Ⅲ grade 5; rheumatic heart disease in 23 cases, the crown l3 cases of heart disease, dilated cardiomyopathy in 6 cases; 9 patients with hypertension, atrial fibrillation l7 cases, 5 cases of premature ventricular contractions, l4 cases of pulmonary infection; rheumatic heart disease with mitral valve disease in the majority (mitral stenosis and regurgitation) with or without other valvular lesions. 1.2 Treatment of 5% or 10% glucose solution by adding sodium nitroprusside 12.55 ah mouth, DA 20-4o, 20, a uranium dobutamine to 5-6 drops / mln infusion started, gradually to l5-20 drops / min to maintain. To observe the blood pressure, heart rate, adjust the drip rate at any time, dark infusion, new drugs with new use, with replacement of fresh solution every 8h. By 1 according to the severity / d (8 hours) to 24h do not ask off intravenous infusion, can be as appropriate as digitalis preparations, diuretics, and anti-infection, to correct arrhythmias, maintenance of water and electrolyte and acid-base balance. Criteria of efficacy ① 1.3: According to symptoms, signs and other comprehensive decision, effective for the improvement of cardiac function Ⅱ, heart failure fully corrected; effective for the improvement of cardiac function grade I; invalid as no change in heart function, or worse. ② effect: 42 cases, 22 cases markedly effective l7 cases and 3 cases, total effective rate was 92.9%. 2 discussion paper argues that sodium nitroprusside, dopamine, dobutamine infusion for the following conditions associated units: ① severe heart failure, severe illness, the application of digitalis preparations, agents and the general vasodilator agent Lee feces poor efficacy; ② chronic repeated application of heart failure digitalis preparations, diuretics and vasodilators agents have been generally tolerated, or digitalis overdose, or electrolyte imbalance; ◎ clinical manifestations is difficult to distinguish inadequate or excessive digitalis, and determination of serum digitalis concentration of unconditional ; ④ have absolute or relative contraindications digitalis; ⑤ of the digitalis-sensitive. SNP is a fast short-acting vasodilators, 42 * equal expansion of small arteries and small veins, the expansion of small arteries decreased cardiac afterload,You are not allowed to view links. Register or Login, the cardiac output, increased ejection fraction, left ventricular end diastolic pressure and pulmonary capillary wedge pressure decreased, while the expansion of small venous preload reduction, change thy blood less, reducing ventricular filling pressure, thereby correcting heart failure. SNP rapid onset, stable disease should be decreasing the amount of antihypertensive effect of sodium nitroprusside to prevent significant, especially for heart failure with hypertension. SNP can reduce the heart before and after the load, but does not increase cardiac contractile force, so to correct heart failure, the need is equipped with positive inotropic drugs, such as dopamine. SNP does not spike be, shall be equipped with new use of new, dark intravenous infusion, after preparation using the best of not more than 8h; and significantly lowering blood pressure should be controlled drip rate; long asked large dose of thiocyanate poisoning can occur. There were no significant side effects l cases, we may control the amount of drugs, medication and close observation time of illness. Dopamine can be excited B, a adrenergic receptor and dopamine receptors, treatment of heart failure should be 25 per minute palate / kg. When every minute 2-5 ~ g & g intravenous infusion, the heart of the island can be excited receptors, increased myocardial contractile force,You are not allowed to view links. Register or Login, give full play to the positive inotropic effect, while Fen renal artery, mesenteric artery dopamine receptors, increasing renal blood can increase urine flow, to stop or delay kidney failure, and the role this time is not yet clear peripheral vasoconstriction, increased heart rate is not obvious. When> lkg · H Qu infusion, the peripheral significant contraction,You are not allowed to view links. Register or Login, increased cardiac afterload, an increase of myocardial oxygen consumption, while enabling faster heart rate, renal blood flow reduction, the treatment of heart failure, but harmful, it should be based on blood pressure, heart rate, urine output dropping speed adjustment. For those who associated with increased peripheral resistance and so can be combined with sodium nitroprusside. Dobutamine is a synthetic adrenal tangled mouth and a receptor stimulants, on the island of selective Sheng Qiang (Island>> a), there was a positive inotropic effect, thereby increasing myocardial contractility, cardiac output increased, heart failure and low blood holding is particularly applicable. As the weak island effect, and a role even worse, it increases heart rate and contraction of the peripheral role of weak, and thus superior to dopamine. In conclusion, sodium nitroprusside, dopamine, dobutamine combined with three drugs, can reduce the incidence of side effects, but also with each other to make up for shortcomings, to maximize the correct heart failure. In addition the system can and digitalis Hao, Lee feces agent at the same time applications, but also in the digitalis preparations, diuretics play a role can not be applied. Therefore, this therapy for the treatment of congestive heart failure, severe heart failure in particular, strong measures in clinical worth promoting. Received: 1999 a still a 20
With digitalis preparations, Lee feces agents can not be corrected by the general vasodilators by sodium nitroprusside,You are not allowed to view links. Register or Login, dopamine, dobutamine infusion combined with satisfactory effect, reported as follows. General information 1 ll clinical data in 42 cases,You are not allowed to view links. Register or Login, male 25 down, female l7, age plus one 7o years old, average age s5; cardiac function by NHYA grade: Ⅳ grade cases, Ⅲ grade 5; rheumatic heart disease in 23 cases, the crown l3 cases of heart disease, dilated cardiomyopathy in 6 cases; 9 patients with hypertension, atrial fibrillation l7 cases, 5 cases of premature ventricular contractions, l4 cases of pulmonary infection; rheumatic heart disease with mitral valve disease in the majority (mitral stenosis and regurgitation) with or without other valvular lesions. 1.2 Treatment of 5% or 10% glucose solution by adding sodium nitroprusside 12.55 ah mouth, DA 20-4o, 20, a uranium dobutamine to 5-6 drops / mln infusion started, gradually to l5-20 drops / min to maintain. To observe the blood pressure, heart rate, adjust the drip rate at any time, dark infusion, new drugs with new use, with replacement of fresh solution every 8h. By 1 according to the severity / d (8 hours) to 24h do not ask off intravenous infusion, can be as appropriate as digitalis preparations, diuretics, and anti-infection, to correct arrhythmias, maintenance of water and electrolyte and acid-base balance. Criteria of efficacy ① 1.3: According to symptoms, signs and other comprehensive decision, effective for the improvement of cardiac function Ⅱ, heart failure fully corrected; effective for the improvement of cardiac function grade I; invalid as no change in heart function, or worse. ② effect: 42 cases, 22 cases markedly effective l7 cases and 3 cases, total effective rate was 92.9%. 2 discussion paper argues that sodium nitroprusside, dopamine, dobutamine infusion for the following conditions associated units: ① severe heart failure, severe illness, the application of digitalis preparations, agents and the general vasodilator agent Lee feces poor efficacy; ② chronic repeated application of heart failure digitalis preparations, diuretics and vasodilators agents have been generally tolerated, or digitalis overdose, or electrolyte imbalance; ◎ clinical manifestations is difficult to distinguish inadequate or excessive digitalis, and determination of serum digitalis concentration of unconditional ; ④ have absolute or relative contraindications digitalis; ⑤ of the digitalis-sensitive. SNP is a fast short-acting vasodilators, 42 * equal expansion of small arteries and small veins, the expansion of small arteries decreased cardiac afterload,You are not allowed to view links. Register or Login, the cardiac output, increased ejection fraction, left ventricular end diastolic pressure and pulmonary capillary wedge pressure decreased, while the expansion of small venous preload reduction, change thy blood less, reducing ventricular filling pressure, thereby correcting heart failure. SNP rapid onset, stable disease should be decreasing the amount of antihypertensive effect of sodium nitroprusside to prevent significant, especially for heart failure with hypertension. SNP can reduce the heart before and after the load, but does not increase cardiac contractile force, so to correct heart failure, the need is equipped with positive inotropic drugs, such as dopamine. SNP does not spike be, shall be equipped with new use of new, dark intravenous infusion, after preparation using the best of not more than 8h; and significantly lowering blood pressure should be controlled drip rate; long asked large dose of thiocyanate poisoning can occur. There were no significant side effects l cases, we may control the amount of drugs, medication and close observation time of illness. Dopamine can be excited B, a adrenergic receptor and dopamine receptors, treatment of heart failure should be 25 per minute palate / kg. When every minute 2-5 ~ g & g intravenous infusion, the heart of the island can be excited receptors, increased myocardial contractile force,You are not allowed to view links. Register or Login, give full play to the positive inotropic effect, while Fen renal artery, mesenteric artery dopamine receptors, increasing renal blood can increase urine flow, to stop or delay kidney failure, and the role this time is not yet clear peripheral vasoconstriction, increased heart rate is not obvious. When> lkg · H Qu infusion, the peripheral significant contraction,You are not allowed to view links. Register or Login, increased cardiac afterload, an increase of myocardial oxygen consumption, while enabling faster heart rate, renal blood flow reduction, the treatment of heart failure, but harmful, it should be based on blood pressure, heart rate, urine output dropping speed adjustment. For those who associated with increased peripheral resistance and so can be combined with sodium nitroprusside. Dobutamine is a synthetic adrenal tangled mouth and a receptor stimulants, on the island of selective Sheng Qiang (Island>> a), there was a positive inotropic effect, thereby increasing myocardial contractility, cardiac output increased, heart failure and low blood holding is particularly applicable. As the weak island effect, and a role even worse, it increases heart rate and contraction of the peripheral role of weak, and thus superior to dopamine. In conclusion, sodium nitroprusside, dopamine, dobutamine combined with three drugs, can reduce the incidence of side effects, but also with each other to make up for shortcomings, to maximize the correct heart failure. In addition the system can and digitalis Hao, Lee feces agent at the same time applications, but also in the digitalis preparations, diuretics play a role can not be applied. Therefore, this therapy for the treatment of congestive heart failure, severe heart failure in particular, strong measures in clinical worth promoting. Received: 1999 a still a 20