Con: TEE is not a routine monitor in anesthesia for cardiac surgery.
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Biomedical subjects
Publications and source records attributed to R Bondy.
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This study was undertaken in order to compare the effectiveness of amrinone and dobutamine as primary treatment of a low cardiac output (CO) after coronary artery bypass graft (CABG) surgery. Thirty patients with preoperative left ventricular dysfunction participated in this open-label randomized study. Patients were included if they failed to separate from cardiopulmonary bypass (CPB) without inotropic support or if they had a cardiac index (CI) less than 2.4 L/min/m2 after CPB regardless of the blood pressure, in the presence of adequate filling pressures. The treatment objectives were to separate from CPB and achieve a CI > or = 2.4 L/min/m2 and a mean arterial pressure > or = 70 mmHg. Patients treated with amrinone received 0.75 mg/kg followed by 10 micrograms/kg/min; when the objectives were not achieved within five minutes, another 0.75 mg/kg was given. Patients treated with dobutamine received an initial infusion of 5 micrograms/kg/min increased stepwise to 15 micrograms/kg/min if necessary. Eleven of 15 amrinone versus 6 of 15 dobutamine patients achieved the predefined treatment objectives with the test drug alone (P = NS). Comparisons of hemodynamics in patients treated solely with amrinone (n = 7) or dobutamine (n = 6) after CPB showed no significant differences between the treatment groups. The incidence of myocardial ischemia as detected by Holter monitor was 36% with amrinone and 33% with dobutamine. Two patients suffered ventricular fibrillation and two had significant supraventricular tachyarrhythmias (heart rate > 130/min) during treatment with dobutamine alone, whereas no significant arrhythmias occurred in the amrinone group (P = NS). Six dobutamine patients (40%) had postoperative myocardial infarction (MI) as opposed to none among the amrinone patients (P = 0.017). These results indicate that amrinone compares favorably with dobutamine as a primary treatment of low CO after CABG. Further study in a larger number of patients will be required in order to determine if the lower incidence of MI in the amrinone group was due to the treatment drug.
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Males rats of the Wistar strain (Institute of Physiology, CSAV ) were divided into six groups from the 30th to the 200th day of age. Rats (n = 54) were put into cages in various numbers (1, 2, 3, 4, 6 and 8 animals in a cage) and were weighed regularly and the consumption of water and food was measured. At the end of the experiment the animals were killed and the weight of some organs and haematological values were determined. During the experiment the highest weight was attained in animals with 3 or 4 members in one cage. The differences in weight were significant from the 80th day of age. The consumption of diets and water was not influenced significantly by the number of animals in a cage. On the 200th day, the differences between the groups were found in the weight of some organs, and in some haematological values.
The composition of diets used for breeding and experimentation on laboratory animals is one of the important factors affecting the quality of the animals and the comparison of experimental data between different laboratories. Six diets used either at the Institute of Physiology, Czechoslovak Academy of Sciences in Prague, or in the Research Centre of Molecular Biology and Medicine, Academy of Sciences GDR in Berlin were analysed for moisture, crude protein, fat, fibre, ash, sodium, potassium, calcium, magnesium, phosphorus and chloride and fed to Wistar rats for 70 and 112 days. Weight gains of the animals were compared and statistically evaluated. The greatest weight gains were achieved with animals fed on the DOS 2b diet.
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