Abstract
The primary concerns of lowering elevated blood pressure values during coronary- artery surgery are the reduction of myocardial oxygen demand and, in some cases, the improvement of left ventricular performance. Peripherally acting vasodilators like sodium nitroprusside (SNP) or nitroglycerin (NTG) are preferably applied. Their mode of action is characterized by a quick fall of arterial blood pressure which promptly rises on discontinuation of the vasodilators. Thus, hypertensive periods frequently occurring intraoperatively in patients with coronary heart disease (CHD) can be safely managed [4, 6]. The changes in circulatory homeostasis induced by the deliberate hypotension are compensated for by a reflex increase in heart rate and associated with alterations of respiratory function. The latter manifest themselves in a decrease of arterial oxygen pressure (PaO2) and an elevated venous admixture [1, 3, 5, 7, 8].
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