Korean J Anesthesiol.  2007 May;52(5):571-577. 10.4097/kjae.2007.52.5.571.

The Effect of Phenylephrine on Cardiac Performance and Myocardial Oxygen Balance in Resuscitation from Hemorrhagic Shock

• Hwang BH
• Hong SJ
• Jeon SS
• Choi JH
• Lee HJ

• KMID: 2239877
• DOI: http://doi.org/10.4097/kjae.2007.52.5.571

Abstract

BACKGROUND: The issue of using phenylephrine in hemorrhagic shock treatment has been controversial because it is known that phenylephrine improves the tissue perfusion by increasing arterial blood pressure but deteriorates the myocardium by increasing afterload and decreasing myocardial oxygen delivery via coronary vasoconstriction. This study was aimed to assess the effects of phenylephrine on hemodynamic variables, cardiac performance, and myocardial oxygen balance in resuscitation from hemorrhagic shock.
METHODS
Twenty anesthetized dogs were randomly divided into phenylephrine group and control group. After inducing hemorrhagic shock, resuscitation was done with phenylephrine and 0.9% normal saline respectively. We measured hemodynamic indices, blood gas parameter and cardiac enzymes which indicate myocardial demage.
RESULTS
In both groups, cardiac output and hemodynamic indices improved. In phenylephrine group, the systemic oxygen delivery and consumption was much higher and the myocardial oxygen extraction ratio was maintained at the lower level than the control group. In addition, the CK-MB was higher at the early phase of resuscitation and the troponin T was also higher than the control group during the whole period of resuscitation. Creatine kinase-MB increased during early resuscitation in phenylephrine group but kept decreasing after that and there's no difference between two groups. Troponin T was higher in the phenylephrine group after resuscitation.
CONCLUSIONS
We concluded that phenylephrine improves myocardial oxygen balance and contractility without serious myocardial demage during resuscitation from hemorrhagic shock.

Keyword

cardiac performance; contractility; hemodynamic indices; hemorrhagic shock; myocardial oxygen balance; phenylephrine

MeSH Terms

Animals
Arterial Pressure
Cardiac Output
Creatine
Dogs
Hemodynamics
Myocardium
Oxygen*
Perfusion
Phenylephrine*
Resuscitation*
Shock, Hemorrhagic*
Troponin T
Vasoconstriction
Creatine
Oxygen
Phenylephrine
Troponin T