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판막수술을 시행 받는 환자에서 레닌-안지오텐신계 길항제가 체외순환 후 요골-대퇴동맥압 간의 차이에 미치는 영향

Other Titles
 Effect of Preoperative Renin-Angiotensin System Antagonists on the Difference between Radial and Femoral Arterial Pressure after Cardiopulmonary Bypass in Patients Undergoing Valvular Heart Surgery 
Authors
 김대희  ;  곽영란  ;  방서욱  ;  차재호  ;  심재광  ;  이종화 
Citation
 KOREAN JOURNAL OF ANESTHESIOLOGY, Vol.53(2) : 199-205, 2007 
Journal Title
 KOREAN JOURNAL OF ANESTHESIOLOGY 
ISSN
 2005-6419 
Issue Date
2007
Abstract
Background Femoral to radial arterial pressure gradient (ΔP) often develops after cardiopulmonary bypass (CPB) where radial artery pressure (RAP) does not reflect the actual perfusion pressure. Renin-angiotensin system antagonists (RAS-A) are increasingly prescribed preoperatively which causes vasodilation and vascular remodeling. We evaluated the effect of RAS-A medication on ΔP after CPB in patients undergoing valvular heart surgery. Methods Eighty-five patients scheduled for elective valvular heart surgery for regurgitant lesions were divided into two groups: the RAS-A group, in which patients were on RAS-A preoperatively (n = 52) and the control group (n = 33). Hemodynamic variables including RAP, femoral arterial pressure (FAP), body temperature, and hematocrit were recorded at after induction of anesthesia, pre-and post-CPB and sternum closure. Results After CPB, systolic ΔP was significantly greater in the RAS-A group than in the control group. Nine (27%) and 36 (69%) patients after CPB, and 6 (18%) and 23 (44%) patients after sternum closure developed systolic ΔP more than 10 mmHg, in the control and RAS-A group, respectively, which were statistically significant. Body temperature, hematocrit and systemic vascular resistance index were not different between groups. Conclusions Preoperative treatment with RAS-A resulted in clinically significant ΔP after cardiopulmonary bypass in about 70% of patients undergoing valvular heart surgery. Concomitant monitoring of FAP with RAP might be helpful to prevent inadequate vasopressor therapy guided by inaccurate RAP after CPB in this subset of patients.
Files in This Item:
T200700345.pdf Download
DOI
10.4097/kjae.2007.53.2.199
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Bang, Sou Ouk(방서욱)
Shim, Jae Kwang(심재광) ORCID logo https://orcid.org/0000-0001-9093-9692
Lee, Jong Wha(이종화)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/96826
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