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Citations to this article

Hemodynamic effects of isoproterenol and norepinephrine in acute cardiac tamponade
Noble O. Fowler, John C. Holmes
Noble O. Fowler, John C. Holmes
Published March 1, 1969
Citation Information: J Clin Invest. 1969;48(3):502-507. https://doi.org/10.1172/JCI106007.
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Research Article

Hemodynamic effects of isoproterenol and norepinephrine in acute cardiac tamponade

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Abstract

The hemodynamic effects of isoproterenol infusion, 0.5 μg/kg per min were evaluated in eight intact anesthetized dogs during cardiac tamponade. During tamponade, the mean of pericardial pressures was increased from — 1.5 to 12.5 mm Hg, and the mean of right atrial pressures was increased from 1 to 12.4 mm Hg. Mean cardiac output fell from 144.8 to 44.8 ml/kg per min (P < 0.001), and rose to 105.6 ml/kg per min (P < 0.001) with isoproterenol. Mean cardiac stroke volume fell from 20.3 to 6.1 ml during tamponade (P < 0.001) and rose to 12.1 ml with isoproterenol (P < 0.001). The heart rate increased from 193.3 beats/min during tamponade to 217.5 beats/min with isoproterenol (P < 0.05). During isoproterenol infusion, the mean right atrial pressure and mean pericardial pressure decreased significantly. With cardiac tamponade, the mean blood pressure fell from 157.5 to 126.1 mm Hg (P < 0.01) and did not change significantly with isoproterenol, 11 additional animals were studied with norepinephrine infusion during tamponade. There were no consistent hemodynamic effects with infusions of 0.5 and 1 μg/kg per min. With norepinephrine 2, 5, and 10 μg/kg per min cardiac output rose in some experiments. Isoproterenol infusion increased the cardiac output during tamponade principally by increasing cardiac stroke volume and to a lesser degree by increasing the heart rate. It is postulated that the increased stroke volume resulted from an increased ejection fraction with greater decrease in end-systolic than end-diastolic ventricular volume. These effects are consistent with the known positive inotropic, peripheral vasodilator, and positive chronotropic effects of isoproterenol.

Authors

Noble O. Fowler, John C. Holmes

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