{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T19:11:17Z","timestamp":1765393877016,"version":"3.46.0"},"reference-count":10,"publisher":"BMJ","issue":"6212","license":[{"start":{"date-parts":[[1980,2,16]],"date-time":"1980-02-16T00:00:00Z","timestamp":319507200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br Med J"],"published-print":{"date-parts":[[1980,2,16]]},"abstract":"<jats:p>The haemodynamic effects of a simultaneous infusion of salbutamol and nitroprusside were measured in 20 patients with acute myocardial infarction and severe left ventricular failure. Six patients also had clinical manifestations of cardiogenic shock. Ten patients received salbutamol first with the subsequent addition of nitroprusside; in the other 10 patients nitroprusside was infused first. Salbutamol was infused at a constant rate of 20 micrograms\/min in all patients, while the dose of nitroprusside, which averaged 51.25 micrograms\/min, was adjusted to reduce left ventricular filling pressure (measured as pulmonary artery end-diastolic pressure) to approximately 15 mm Hg with reference to sternal angle. Cardiac index increased in all patients from a mean of 1.8 to 2.6 l\/min\/m2 while pulmonary artery end-diastolic pressure fell significantly from 24 to 16 mm Hg. The adverse effects were small in most patients: heart rate did not increase significantly and systolic arterial pressure fell on average from 112 to 96 mm Hg. Ten of the 20 patients survived to leave hospital. Nitroprusside accounted for most of the fall in filling pressure irrespective of treatment sequence, whereas both drugs contributed to the augmented cardiac output. The haemodynamic benefits of this combined regimen were considerably greater than those achieved by either drug alone. Thus salbutamol and nitroprusside have synergistic effects which influence favourably the two principal manifestations of left ventricular dysfunction after extensive myocardial infarction.<\/jats:p>","DOI":"10.1136\/bmj.280.6212.435","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T18:32:30Z","timestamp":1238697150000},"page":"435-437","source":"Crossref","is-referenced-by-count":5,"title":["Synergistic effects of a combined salbutamol-nitroprusside regimen in acute myocardial infarction and severe left ventricular failure."],"prefix":"10.1136","volume":"280","author":[{"given":"M B","family":"Fowler","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A D","family":"Timmis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D A","family":"Chamberlain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1980,2,16]]},"reference":[{"issue":"1971","key":"ref_1","first-page":"40","article-title":"Haemodynamic effects of intravenous salbutamol in patients with mitral valve disease: comparison with isoprenaline and atropine","volume":"7","author":"Gibson, D.G.; Coltart, D.J.","unstructured":"Gibson DG, Coltart DJ. Haemodynamic effects of intravenous salbutamol in patients with mitral valve disease: comparison with isoprenaline and atropine. Postgrad MedJ7 1971;47,suppl 1:40-4.","journal-title":"Postgrad"},{"key":"ref_2","first-page":"1101","article-title":"Haemodynamic effects of salbutamol in patients with acute myocardial infarction and severe left ventricular dysfunction","author":"Timmis, A.D.; Strak, S.K.; Chamberlain, D.A.","year":"1979","unstructured":"Timmis AD, Strak SK, Chamberlain DA. Haemodynamic effects of salbutamol in patients with acute myocardial infarction and severe left ventricular dysfunction. Br MedJ 1979;ii.1101-3.","journal-title":"Br MedJ"},{"key":"ref_3","first-page":"650","article-title":"Improved left ventricular function during nitroprusside infusion in acute myocardial infarction","volume":"i:","author":"Franciosa, J.A.; Guiha, N.H.; Limas, C.J.; Rodriguera, E.; Cohn, J.N.","year":"1972","unstructured":"Franciosa JA, Guiha NH, Limas CJ, Rodriguera E, Cohn JN. Improved left ventricular function during nitroprusside infusion in acute myocardial infarction. Lancet 1972;i:650-4.","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1161\/01.CIR.48.6.1183","article-title":"Hemodynamic and metabolic responses to vasodilator therapy in acute myocardial infarction","volume":"48","author":"Chatterjee, K.; Parmley, W.W.; Ganz, W.","year":"1973","unstructured":"Chatterjee K, Parmley WW, Ganz W, et al. Hemodynamic and metabolic responses to vasodilator therapy in acute myocardial infarction. Circulation 1973;48:1183-93.","journal-title":"Circulation"},{"issue":"1118-22","key":"ref_5","first-page":"1196","article-title":"Vasodilator therapy in acute myocardial infarction: a comparison of sodium nitroprusside and nitroglycerin","volume":"52","author":"Armstrong, P.W.; Walker, D.C.; Burton, JR, Parker; J.O.","year":"1975","unstructured":"Armstrong PW, Walker DC, Burton JR, Parker JO. Vasodilator therapy in acute myocardial infarction: a comparison of sodium nitroprusside and nitroglycerin. Circulation 1975;52:1118-22. 6 Kotter V, Von Leitner ER, Wunderlich J, Schroder R. Comparison of haemodynamic effects of phentolamine, sodium nitroprusside, and glyceryl trinitrate in acute myocardial infarction. Br Heart J 1977; 39:1196-204.","journal-title":"Circulation; Comparison of haemodynamic effects of phentolamine, sodium nitroprusside, and glyceryl trinitrate in acute myocardial infarction"},{"key":"ref_6","first-page":"51","article-title":"Hemodynamic profile in acute myocardial infarction","author":"Chatterjee, K.; Swan, H.J.C.","year":"1973","unstructured":"Chatterjee K, Swan HJC. Hemodynamic profile in acute myocardial infarction. In: Corday E, Swan HJC, eds. Myocardial infarction. Baltimore: Williams and Wilkins, 1973:51-61."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/0002-9149(78)90909-8","article-title":"Combined nitroprussidedopamine therapy in severe chronic congestive heart failure. Doserelated hemodynamic advantages over single drug infusions","volume":"42","author":"Stemple, D.R.; Kleiman, J.H.; Harrison, D.C.","year":"1978","unstructured":"Stemple DR, Kleiman JH, Harrison DC. Combined nitroprussidedopamine therapy in severe chronic congestive heart failure. Doserelated hemodynamic advantages over single drug infusions. Am J Cardiol 1978;42:267-75.","journal-title":"Am J Cardiol"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1161\/01.CIR.56.4.528","article-title":"Comparative hemodynamic effects of inotropic and vasodilator drugs in severe heart failure","volume":"56","author":"Mikulic, E.; Cohn, J.N.; Franciosa, J.A.","year":"1977","unstructured":"Mikulic E, Cohn JN, Franciosa JA. Comparative hemodynamic effects of inotropic and vasodilator drugs in severe heart failure. Circulation 1977;56:528-33.","journal-title":"Circulation"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1097\/00000542-197609000-00016","article-title":"Sodium nitroprusside: pharmacology, toxicology and therapeutics","volume":"45","author":"Tinker, J.H.; Michenfelder, J.D.","year":"1976","unstructured":"Tinker JH, Michenfelder JD. Sodium nitroprusside: pharmacology, toxicology and therapeutics. Anesthesiology 1976;45:340-54.","journal-title":"Anesthesiology"},{"article-title":"Accepted 27","year":"1979","key":"ref_10","unstructured":"(Accepted 27 November 1979)"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.280.6212.435","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.280.6212.435","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T19:06:21Z","timestamp":1765393581000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.280.6212.435"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1980,2,16]]},"references-count":10,"journal-issue":{"issue":"6212","published-online":{"date-parts":[[1980,2,16]]},"published-print":{"date-parts":[[1980,2,16]]}},"alternative-id":["10.1136\/bmj.280.6212.435"],"URL":"https:\/\/doi.org\/10.1136\/bmj.280.6212.435","relation":{},"ISSN":["0007-1447","1468-5833"],"issn-type":[{"type":"print","value":"0007-1447"},{"type":"electronic","value":"1468-5833"}],"subject":[],"published":{"date-parts":[[1980,2,16]]}}}