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- W4247992016 abstract "Protection of myocardium from ischaemia involves detection and recognition of early changes in myocardial function associated with ischaemia as well as use of techniques and agents designed to alleviate or ameliorate ischaemia. However, the decision of which agent to employ depends not only upon the effects of a particular therapy but also the interaction between the therapeutic agent and anaesthetics. Nitroglycerine, beta-blockers, calcium antagonists, and intra-aortic balloon counterpulsation all may have beneficial effects in conscious patients but variable degrees of effectiveness during anaesthesia. Similarly, nitroprusside must be used with caution due to its additive effects upon anaesthesia-induced vasodilation. Inotropes may be needed to support the circulation during anaesthesia, whereas they would only be used with left ventricular failure in conscious patients. Vasoconstrictors may improve subendocardial perfusion and be of particular benefit in patients with pulmonary hypertension, as mild hypotension induced by anaesthesia may significantly decrease right ventricular perfusion. The choice of agents to be used for myocardial protection ultimately depend upon clinical decisions regarding coronary blood supply and myocardial oxygen demand. The availability of several different classes of agents capable of altering a specific physiological variable allows a wide variety of clinical situations to be effectively managed." @default.
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- W4247992016 date "1989-06-01" @default.
- W4247992016 modified "2023-10-16" @default.
- W4247992016 title "Myocardial protection" @default.
- W4247992016 doi "https://doi.org/10.1016/s0950-3501(89)80033-9" @default.
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