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This study was designed to characterize the effects of phenylephrine and ephedrine on dP\/dt and Ea<jats:sub>dyn<\/jats:sub>.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This was a retrospective, non-randomized analysis of data collected during two clinical studies. All patients required intra-operative controlled mechanical ventilation and had an indwelling radial artery catheter connected to an Acumen IQ sensor. Raw arterial pressure waveform data was downloaded from the patient monitor and all hemodynamic measurements were calculated off-line. The anesthetic record was reviewed for bolus administrations of either phenylephrine or ephedrine. Cardiovascular variables prior to drug administration were compared to those following vasopressor administrations. The primary outcome was the difference for dP\/dt and Ea<jats:sub>dyn<\/jats:sub> at baseline compared with the average after the bolus administration. All data sets demonstrated non-normal distributions so statistical analysis of paired and unpaired data followed the Wilcoxon matched pairs signed-rank test or Mann-Whitney U test, respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>201 doses of phenylephrine and 100 doses of ephedrine were analyzed. All data sets are reported as median [95% CI]. Mean arterial pressure (MAP) increased from 62 [54,68] to 78 [76,80] mmHg following phenylephrine and from 59 [55,62] to 80 [77,83] mmHg following ephedrine. Stroke volume and cardiac output both increased. Stroke volume variation and pulse pressure variation decreased. Both drugs produced significant increases in dP\/dt, from 571 [531, 645] to 767 [733, 811] mmHg\/sec for phenylephrine and from 537 [509, 596] to 848 [779, 930] mmHg\/sec for ephedrine. No significant changes in Ea<jats:sub>dyn<\/jats:sub> were observed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Bolus administration of phenylephrine or ephedrine increases dP\/dt but does not change Ea<jats:sub>dyn<\/jats:sub>. dP\/dt demonstrates potential for predicting the inotropic response to phenylephrine or ephedrine, providing guidance for the most efficacious vasopressor when treating hypotension.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>Data was collected from two protocols. The first was deemed to not require written, informed consent by the Institutional Review Board (IRB). The second was IRB-approved (Effect of Diastolic Dysfunction on Dynamic Cardiac Monitors) and registered on ClinicalTrials.gov (NCT04177225).<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12871-024-02574-x","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T08:02:16Z","timestamp":1722240136000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A retrospective study of the effects of a vasopressor bolus on systolic slope (dP\/dt) and dynamic arterial elastance (Eadyn)"],"prefix":"10.1186","volume":"24","author":[{"given":"Alexa C.","family":"Abdallah","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang H","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neal W.","family":"Fleming","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,7,29]]},"reference":[{"key":"2574_CR1","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1097\/01.anes.0000270724.40897.8e","volume":"107","author":"WA van BijkerJB","year":"2007","unstructured":"van BijkerJB WA, Kappen TH, et al. 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The first protocol was an evaluation of non-invasive cardiac output monitors in patients undergoing elective cardiac surgery. This study was deemed to not require written, informed consent by the University of California, Davis Institutional Review Board (IRB) as part of a quality improvement project. The second protocol was an IRB-approved prospective evaluation of the effects of diastolic function on the dynamic monitors of cardiac function (Effect of Diastolic Dysfunction on Dynamic Cardiac Monitors, NCT04177225). All patients in this second protocol provided written, informed consent.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Neal Fleming has supported contracted research for Acacia Pharma, Tsumera Pharmaceuticals, Haisco Pharmaceuticals, Masimo, Inc. and Edwards LifeSciences and received honoraria from Edwards LifeSciences for invited presentations.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"257"}}