Interrelationships of hepatic blood flow, cardiac output, and blood levels of lidocaine in man
Factors that regulate the arterial level of lidocaine during a constant infusion were investigated in 17 patients undergoing cardiac catheterization. Lidocaine was administered by a 50 mg bolus, followed by a constant infusion of 40 µg/kg/min until steady state conditions were achieved. Cardiac outp...
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Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 1971-02, Vol.43 (2), p.205-211 |
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Zusammenfassung: | Factors that regulate the arterial level of lidocaine during a constant infusion were investigated in 17 patients undergoing cardiac catheterization. Lidocaine was administered by a 50 mg bolus, followed by a constant infusion of 40 µg/kg/min until steady state conditions were achieved. Cardiac output and estimated hepatic blood flow were also determined. An inverse relationship between arterial lidocaine levels and cardiac index was observed. With a low cardiac index of 1.9 ± 0.3 liters/min/m
2
the arterial level was 2.4 (±0.4
sem
) µg/ml, while with a normal cardiac index of 3.3 ± 0.8 liters/min/m
2
it was 1.5 (±0.2
sem
) µ/ml.
A linear relationship was also observed between estimated hepatic blood flow and cardiac index. Therefore, an inverse relationship between arterial lidocaine levels and estimated hepatic blood flow was noted. At steady-state conditions, the liver accounted for 70% (±16%
sem
) of the metabolism or removal of the lidocaine administered. These studies suggest that the administration of smaller doses of lidocaine will produce effective therapeutic levels when reduced hepatic blood flow exists. |
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ISSN: | 0009-7322 1524-4539 |
DOI: | 10.1161/01.CIR.43.2.205 |