Effects of phenylephrine on cardiac output and venous return depend on the position of the heart on the Frank-Starling relationship

Journal of Applied Physiology
Maxime CannessonFeras Hatib

Abstract

phenylephrine is used daily during anesthesia for treating hypotension. However, the effects of phenylephrine on cardiac output (CO) are not clear. We hypothesized that the impact of phenylephrine on cardiac output is related to preload dependency. eight pigs were studied at a preload independent stage (after CO augmentation) and at a preload dependent stage (after a 21 ml/kg hemorrhage). At each stage, phenylephrine boluses (0.5, 1.0, 2.0, and 4.0 μg/kg) were given randomly while mean arterial pressure (MAP), CO, inferior vena cava flow (IVCf) (both measured using ultrasonic flow probes), and pulse pressure variation were measured. at the preload independent stage, phenylephrine boluses induced significant increases in MAP (from 72 ± 6 to 100 ± 6 mmHg; P < 0.05) and decreases in CO and IVCf (from 7.0 ± 0.8 to 6.0 ± 1.1 l/min and from 4.6 ± 0.5 to 3.8 ± 0.6 l/min, respectively). At the preload-dependent stage, phenylephrine boluses induced significant increases in MAP (from 40 ± 7 to 65 ± 9 mmHg), CO (from 4.1 ± 0.6 to 4.9 ± 0.7 l/min), and IVCf (from 3.0 ± 0.4 to 3.5 ± 0.6 l/min; all data presented are for 4 μg/kg). Incremental doses of phenylephrine induced incremental changes in cardiac output. A pulse pressure variation >16...Continue Reading

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Citations

Sep 21, 2013·Journal of Clinical Monitoring and Computing·Youn Yi JoHyun Jeong Kwak
Jul 17, 2014·Journal of Cardiothoracic and Vascular Anesthesia·Koichi SuehiroKiyonobu Nishikawa
Oct 23, 2014·BMC Anesthesiology·Martijn van LavierenBenno Lansdorp
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Jun 5, 2021·South African Family Practice : Official Journal of the South African Academy of Family Practice/Primary Care·David G Bishop, Simon P D P Le Roux

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