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| Interpretation of the effect of recombinant brain natriuretic peptide on cardiac output in patients with heart failure by venous reflux curve |
| LIU Jianling YANG Huizhao MING Jianqing LI Jiemin WEN Zhenjie CHEN Jun ZHANG Ming Lin Qinhan ZHOU Haibo |
| Area 1, ICU, Qingyuan People′s Hospital, Guangdong Province, Qingyuan 511500, China |
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Abstract Objective To explore the effect of recombinant brain natriuretic peptide on cardiac output (CO) in patients with heart failure by using venous reflux curve. Methods From July 2014 to May 2017, in ICU, Qingyuan People′s Hospital, 45 patients with congestive heart failure were selected, and the basic information before the treatment were recorded, all patients with congestive heart failure were given the conventional treatment (such as diuretics, digitalis, etc.), and on this basis of conventional treatment, the recombinant brain natriuretic peptide was administered by continuous intravenous infusion for 24 h at the loading dose. The mean arterial pressure (MAP), cardiac output (CO), stroke volume (SV), central venous pressure (CVP), mean systemic filling pressure (Pmsf), resistance for venous return (RVR), systemic vascular resistance (SVR), stroke volume variation (SVV) were recorded before 0 min and 30 min, 3 h after the treatment. The collected hemodynamic parameters were used to calculate the indicators to draw the venous reflux curve. Other data were analyzed by statistical analysis before and after comparison. Results Compared with 0 min before drug administration, CO increased and SVR decreased 30 min after drug administration, the differences were statistically significant (P < 0.05 or P < 0.01); CO and CVP increased, while RVR and SVR decreased 3 h after drug administration, the differences were statistically significant (P < 0.05 or P < 0.01). Compared with 30 min after drug administration, CVP increased, MAP, Pmsf and RVR decreased 3 h after drug administration, the differences were statistically significant (P < 0.05 or P < 0.01). The venous reflux curve shows that with the continuous increasing of CVP, the CO of patients with recombinant brain natriuretic peptide decrease continuously at 0 min before drug administration and 30 min and 3 h after drug administration. Conclusion Recombinant human brain natriuretic peptide can increase CO in patients with acute heart failure, possibly by reducing peripheral circulatory resistance and reducing cardiac after load. At the later stage, the effect of peripheral circulation resistance has decreased, but RVR has decreased, thus increasing the venous reflux and increasing the patients′ CO.
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