Clinical research of the therapeutic effect of esmolol on refractory ventricular fibrillation occurred after release of aortic cross-clamp during cardiopulmonary bypass / 中华胸心血管外科杂志

ABSTRACT

Objective To evaluate the effect of esmolol on refractory veatricular fibrillation just after aortic declamp during cardiopulmonary bypass.Methods 40 patients undergoing valve replacement occurring refractory ventricular fibrillation after release of aortic cross-clamp was randomly given esmolol (prepared to 10 mg/ml) 1 mg/kg(group esmolol,n =20),or Lidocaine (prepared to 10 mg/ml) 1 mg/kg(group control,n=20),the endocardial electric defibrillation was continued after 2min.If the fibrillation still can not be reversed after another two times defribrillation,the routine clinical method would beused.The time of aortic cross-clamp,rectal temperature,MAP,and the value of serum Lactic acid,potassium,and PH were recorded.After intervention,the times of defibrillation,heart rate and rhythm 5 min after reversal were recorded.At the end of CPB,the CPB time and the dosage of positive inotropic drugs were also recorded.Results The success rate of defibrillation was higer in group esmolol than control group(P ＜0.05).Heart rate after reversal in group esmolol were slower than that in control group(P ＜ 0.05).The CPB time of control group was longer than group esmolol (P ＜ 0.05),and the dosage of positiveinotropic drugs was significantly higher in control group(P ＜ 0.01).Conclusion When occurring refractory ventricular fibrillation just after aortic declamp during CPB,Using esomolol by way of intravenous infusion can apparently reduce the frequency of defibrillation,and improve the rate of rewersal.It can also be favorable to cardiac function,and decrease the dependency of positive inotropic drugs,and shorten the time of CPB.