Iranian Heart Journal

Iranian Heart Journal

Effects of Epinephrine, Norepinephrine, and Phenylephrine on Cerebral Oxygen Saturation in Patients Undergoing Cardiopulmonary Bypass: A Randomized Clinical Trial

Document Type : Original Article

Authors
Mohsen Ziyaeifard 1
Reza Rostami 2
Rasoul Azarfarin 1
Alireza Yaghoubi-Golverdi 2
Mostafa Fattahi 2
Javad Jamalian 2
1 Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
2 Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
Abstract
Background: Epinephrine, norepinephrine, and phenylephrine may have different effects on cerebral O2 saturation when used to treat intraoperative hypotension. The present study aimed to evaluate these effects on cerebral O2 saturation in patients undergoing cardiopulmonary bypass (CPB) during heart surgeries.
Methods: The current randomized clinical trial enrolled 114 adult patients, 90 of whom were eligible for randomization into 3 groups (each=30) receiving epinephrine, norepinephrine, and phenylephrine if they experienced hypotension (mean arterial pressure [MAP]<60 mm Hg) during surgery. Cerebral oximetry as the primary outcome, hemodynamic parameters, consisting of heart rate, MAP, and arterial blood gas (ABG), and lactate levels were recorded prior to surgery and 120, 150, and 180 seconds after vasopressor administration during CPB.
Results: The 3 study groups were similar regarding demographic variables. Hemodynamic parameters, including ABG, and lactate levels showed no statistically significant differences between the groups (P>0.05). Additionally, cerebral O2 saturation at baseline and 120, 150, and 180 seconds after vasopressor administration was not statistically different between the 3 groups (P>0.05).
Conclusions: The administration of epinephrine, norepinephrine, or phenylephrine in adult patients undergoing cardiac surgery with CPB support yielded no statistically significant differences in clinical and hemodynamic parameters. (Iranian Heart Journal 2023; 24(2): 6-13)
Keywords
Vasopressor
Cardiopulmonary bypass
Cardiac surgical procedures
Oximetry
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Iranian Heart Journal
Volume 24, Issue 2
Spring 2023
Pages 6-13