Use of low-dose β1-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study

Michihiro Sakai; Satoshi Jujo; Junjiro Kobayashi; Yoshihiko Ohnishi; Masataka Kamei

doi:10.1186/s13019-019-0966-z

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Use of low-dose β1-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study

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Use of low-dose β1-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study

Michihiro Sakai, Satoshi Jujo, Junjiro Kobayashi, Yoshihiko Ohnishi and Masataka Kamei

Journal of cardiothoracic surgery, Vol.14(1), 145

07/25/2019

DOI: 10.1186/s13019-019-0966-z

PMCID: PMC6659295

PMID: 31345252

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Abstract

Background Sinus tachycardia coupled with high-dose catecholamine is common after cardiopulmonary bypass (CPB). The present study assessed the hemodynamic efficacy and safety of combination therapy using low-dose β1-selective adrenergic blocker (landiolol) and inotropes. Methods This was a retrospective, single center, self-comparison study at post-anesthesia care unit within a tertiary care center. The study included adults who underwent cardiac surgery with CPB and received landiolol between April 2007 and November 2011. We assessed hemodynamic data prior to and 1 h after initiation of landiolol therapy. Results We evaluated 11 patients who were administered 2.6 ± 1.3 μg/kg/min (mean ± SD) landiolol with sinus tachycardia and received catecholamine therapy after on-pump cardiovascular surgery. Landiolol administration led to a significant reduction in heart rate (HR; 112.4 ± 5.8 vs 126.0 ± 7.6 beats/min, p < 0.001), and a significant increase in stroke volume index (SVI) assessed by pulmonary artery catheterization (22.4 ± 5.4 vs. 18.9 ± 4.2 mL/m2, p = 0.04). Only one patient showed no HR reduction, whereas seven patients showed decreased HR and increased SVI (64, 95% confidence interval: 30–98%). Moreover, all five patients who received high-dose catecholamine support showed improved hemodynamics. In terms of safety, no patients required cessation of landiolol therapy. Conclusions Low-dose landiolol therapy may safely decrease HR and improve hemodynamics among patients with sinus tachycardia receiving catecholamine treatment after cardiovascular surgery. Trial registration This study is retrospective. Registration number: 11. Duration of registration: April 2007~November 2011.

Tachycardia

Catecholamine

Cardiovascular surgery

Details

Title: Subtitle: Use of low-dose β1-blocker for sinus tachycardia in patients with catecholamine support following cardiovascular surgery: a retrospective study
Creators: Michihiro Sakai - Mie University Hospital
Satoshi Jujo - National Cerebral and Cardiovascular Center
Junjiro Kobayashi - National Cerebral and Cardiovascular Center
Yoshihiko Ohnishi - National Cerebral and Cardiovascular Center
Masataka Kamei - Mie University Hospital
Resource Type: Journal article
Publication Details: Journal of cardiothoracic surgery, Vol.14(1), 145
DOI: 10.1186/s13019-019-0966-z
PMID: 31345252
PMCID: PMC6659295
NLM abbreviation: J Cardiothorac Surg
ISSN: 1749-8090
eISSN: 1749-8090
Publisher: BioMed Central; LONDON
Language: English
Date published: 07/25/2019
Academic Unit: Anesthesia
Record Identifier: 9985150206302771

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