Calcium does not augment phenylephrine's hypertensive effects

J. F. Butterworth IV, R. A. Strickland, Lynette J Mark, N. D. Kon, G. P. Zaloga

Research output: Contribution to journalArticle

Abstract

Ca and phenylephrine, both of which increase mean arterial pressure (MAP), are often administered concurrently during resuscitation of critically ill patients. To determine whether the response to phenylephrine is potentiated by Ca administration, we studied eight adult patients 24 h after aortocoronary bypass surgery. Each patient received three doses of phenylephrine (150, 300, and 450 ng/kg·min), administered both with and without CaCl2 (5 mg/kg bolus followed by a 2-mg/kg·h infusion). Phenylephrine alone at 150, 300, and 450 ng/kg·min increased MAP by 2%, 6%, and 17%, respectively. Ca alone increased serum ionized Ca levels from 1.00 ± .03 (SEM) to 1.20 ± .02 mM (p <.05) and increased MAP from 84 ± 1 to 90 ± 2 mm Hg (p <.05), but had no effect on cardiac index (CI). When administered concurrently with Ca, phenylephrine at 150, 300, and 450 ng/kg·min increased MAP by 6%, 7%, and 13%, respectively. Phenylephrine had no effect on CI, pulmonary capillary wedge pressure, CVP, or heart rate whether or not it was administered with Ca. We conclude that concomitant Ca administration does not augment the hypertensive response to phenylephrine in normotensive patients recovering from open heart surgery.

Original languageEnglish (US)
Pages (from-to)603-606
Number of pages4
JournalCritical Care Medicine
Volume18
Issue number6
StatePublished - 1990
Externally publishedYes

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Phenylephrine
Calcium
Arterial Pressure
Pulmonary Wedge Pressure
Critical Illness
Resuscitation
Coronary Artery Bypass
Thoracic Surgery
Heart Rate
Serum

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Butterworth IV, J. F., Strickland, R. A., Mark, L. J., Kon, N. D., & Zaloga, G. P. (1990). Calcium does not augment phenylephrine's hypertensive effects. Critical Care Medicine, 18(6), 603-606.

Calcium does not augment phenylephrine's hypertensive effects. / Butterworth IV, J. F.; Strickland, R. A.; Mark, Lynette J; Kon, N. D.; Zaloga, G. P.

In: Critical Care Medicine, Vol. 18, No. 6, 1990, p. 603-606.

Research output: Contribution to journalArticle

Butterworth IV, JF, Strickland, RA, Mark, LJ, Kon, ND & Zaloga, GP 1990, 'Calcium does not augment phenylephrine's hypertensive effects', Critical Care Medicine, vol. 18, no. 6, pp. 603-606.
Butterworth IV JF, Strickland RA, Mark LJ, Kon ND, Zaloga GP. Calcium does not augment phenylephrine's hypertensive effects. Critical Care Medicine. 1990;18(6):603-606.
Butterworth IV, J. F. ; Strickland, R. A. ; Mark, Lynette J ; Kon, N. D. ; Zaloga, G. P. / Calcium does not augment phenylephrine's hypertensive effects. In: Critical Care Medicine. 1990 ; Vol. 18, No. 6. pp. 603-606.
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AB - Ca and phenylephrine, both of which increase mean arterial pressure (MAP), are often administered concurrently during resuscitation of critically ill patients. To determine whether the response to phenylephrine is potentiated by Ca administration, we studied eight adult patients 24 h after aortocoronary bypass surgery. Each patient received three doses of phenylephrine (150, 300, and 450 ng/kg·min), administered both with and without CaCl2 (5 mg/kg bolus followed by a 2-mg/kg·h infusion). Phenylephrine alone at 150, 300, and 450 ng/kg·min increased MAP by 2%, 6%, and 17%, respectively. Ca alone increased serum ionized Ca levels from 1.00 ± .03 (SEM) to 1.20 ± .02 mM (p <.05) and increased MAP from 84 ± 1 to 90 ± 2 mm Hg (p <.05), but had no effect on cardiac index (CI). When administered concurrently with Ca, phenylephrine at 150, 300, and 450 ng/kg·min increased MAP by 6%, 7%, and 13%, respectively. Phenylephrine had no effect on CI, pulmonary capillary wedge pressure, CVP, or heart rate whether or not it was administered with Ca. We conclude that concomitant Ca administration does not augment the hypertensive response to phenylephrine in normotensive patients recovering from open heart surgery.

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