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The Journal of Thoracic and Cardiovascular Surgery, Vol 82, 632-637, Copyright © 1981 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Reduction of systemic vascular resistance by competitive alpha adrenergic blockage with thymoxamine after cardiopulmonary bypass for cardiac operations

AJ Cottrell and DT Pearson

Fifteen patients with evidence of excessive systemic vasoconstriction following cardiac operations were studied. Serial hemodynamic measurements were made before and during infusion of thymoxamine, a competitive alpha adrenergic blocking drug. Thymoxamine resulted in a full in systemic resistance together with a rise in cardiac index without reflex tachycardia. When thymoxamine was infused at a rate of 1 mg . kg-1, the desired effect was achieved without sudden profound falls in arterial pressure and there were no significant side effects. During the first few hours after bypass, skin temperature measurements do not give an adequate indication of the circulatory state. Measurement of mixed venous oxygen saturation is a most useful, simple method of monitoring the acute effects of treatment during this period.