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Effects of olprinone, a new phosphodiesterase inhibitor, on gastric intramucosal acidosis and systemic inflammatory responses following hypothermic cardiopulmonary bypass
Author(s) -
Yamaura K.,
Akiyoshi K.,
Irita K.,
Taniyama T.,
Takahashi S.
Publication year - 2001
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1034/j.1399-6576.2001.045004427.x
Subject(s) - medicine , cardiopulmonary bypass , anesthesia , amrinone , cardiac surgery , pco2 , inotrope , hemodynamics
Background: Phosphodiesterase (PDE) III inhibitors have both an inotropic and a peripheral vasodilatory effect, and also inhibit the activation of macrophages. Thus a newly developed PDE III inhibitor, olprinone, could modify gastric intramucosal pH (pHi), systemic oxygen consumption, and systemic inflammatory responses in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Methods: We studied 23 patients. In 15 patients, olprinone (0.1 or 0.2 μg · kg −1 · min −1 ) was administered from the commencement of CPB until their admission to the ICU. The other 8 patients received placebo. The pHi and regional CO 2 tension (PrCO 2 ) were assessed by a capnometric air tonometry. Systemic inflammatory responses were evaluated by serum interleukin‐6 (IL‐6), IL‐10, and leucocyte counts. Results: The pHi and PCO 2 ‐gap, the difference between PrCO 2 and arterial CO 2 tension (PaCO 2 ), showed a transient decrease and an increase after CPB, respectively. Although olprinone did not affect pHi, olprinone at 0.2 μg · kg −1 · min −1 significantly lessened post‐CPB increase in PCO 2 ‐gap. Olprinone at 0.2 μg · kg −1 · min −1 significantly increased IL‐10 and reduced the extent of leucocytosis, while it did not affect IL‐6 levels. At the same dosage, olprinone also lessened the surge in systemic oxygen uptake index (V˙O 2 ) and augmented the increase in mixed oxygen saturation (Sv¯O 2 ) both of which occurred after CPB. At 0.1 μg · kg −1 · min −1 , however, olprinone did not show any significant effect. Conclusion: Our results suggest that olprinone at 0.2 μg · kg −1 · min −1 suppresses gastric intramucosal acidosis and systemic inflammation following CPB.