Abstract

Comment: Although this was a nonrandomized study, the authors studied patients who received post-bypass therapy in the ICU according to their cardiac index, which was either above or below 1.75 L/m2. No discussion of drugs given before the study period began is included, i.e., post-bypass and before arrival into the ICU. The criteria to determine whether sodium nitroprusside was used in addition to dobutamine are not stated. Also, a cardiac index of 1.75 L/m2 may be an inappropriate threshold for instituting therapy; perhaps a lower threshold might be more informative. This study seems to indicate that splanchnic oxygen delivery is maintained at the expense of peripheral oxygen delivery, when cardiac function is marginal.

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