Asset Details
Do you wish to reserve the book?
Dose-dependent benefit of nitroglycerin on microcirculation of patients with severe heart failure
Hey, we have placed the reservation for you!
By the way, why not check out events that you can attend while you pick your title.
Oops! Something went wrong.
Looks like we were not able to place the reservation. Kindly try again later.
Are you sure you want to remove the book from the shelf?
Dose-dependent benefit of nitroglycerin on microcirculation of patients with severe heart failure
Do you wish to request the book?
Dose-dependent benefit of nitroglycerin on microcirculation of patients with severe heart failure
Please be aware that the book you have requested cannot be checked out. If you would like to checkout this book, you can reserve another copy
We have requested the book for you!
Your request is successful and it will be processed during the Library working hours. Please check the status of your request in My Requests.
Oops! Something went wrong.
Looks like we were not able to place your request. Kindly try again later.
Journal Article
Dose-dependent benefit of nitroglycerin on microcirculation of patients with severe heart failure
2009
Overview
Introduction
Microcirculatory abnormalities are frequently observed in patients with severe heart failure and correlate to worse outcomes. We tested the hypothesis that nitroglycerin dose-dependently improves perfusion in severe heart failure and that this could be monitored by measuring central-peripheral temperature gradient and with Sidestream Dark Field imaging of the sublingual mucosa.
Methods
A dose-response study was performed in 17 patients with cardiogenic shock (
n
= 9) or end-stage chronic heart failure (
n
= 8) admitted to Erasmus University Medical Center. We did hemodynamic measurements at baseline and during increasing infusion rates of nitroglycerin (up to a maximum dose of 133 μg min
−1
). As parameters of tissue perfusion, we measured central-peripheral temperature gradient (delta-T) and sublingual perfused capillary density (PCD).
Results
Nitroglycerin dose-dependently decreased mean arterial pressure (
p
< 0.001) and cardiac filling pressures (both central venous pressure (CVP) and pulmonary capillary wedge pressure:
p
< 0.001). It increased cardiac index (
p
= 0.01). Nitroglycerin decreased delta-T (
p
< 0.001) and increased sublingual PCD (
p
< 0.001). Significant changes in delta-T and PCD occurred earlier, i.e., at a lower doses of NTG, than changes in global hemodynamics. Macrohemodynamic and microcirculatory responses to nitroglycerin infusion were consistent in patients with either cardiogenic shock or end-stage chronic heart failure. Changes in microcirculatory parameters occurred independently of changes in cardiac index.
Conclusions
Nitroglycerin dose-dependently increases tissue perfusion in patients with severe heart failure, as observed by a decrease in central-peripheral temperature gradient and an increase in sublingual perfused capillary density.
Publisher
Springer-Verlag,Springer,Springer Nature B.V
Subject
/ Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
/ Biological and medical sciences
/ Dose-Response Relationship, Drug
/ Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care
/ Female
/ Heart Failure - drug therapy
/ Heart Failure - physiopathology
/ Humans
/ Male
/ Medicine
/ Microcirculation - drug effects
/ Nitroglycerin - administration & dosage
/ Nitroglycerin - pharmacology
/ Original
/ Patients
/ Pneumology/Respiratory System
/ Shock, Cardiogenic - diagnosis
/ Shock, Cardiogenic - drug therapy
/ Shock, Cardiogenic - metabolism
/ Shock, Cardiogenic - physiopathology
/ Vasodilator Agents - administration & dosage
