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Hemodynamic Effects of Intravenous Phentolamine in Low Output Cardiac Failure

SUMMARY Nineteen patients with chronic low output cardiac failure were studied before, during and after infusion of phentolamine in doses of 10, 20, 30 and 40 μg/kg/min. Significant reduction of left- and right-sided pressures and increases in cardiac index and heart rate (HR) were present within 15 minutes of starting phentolamine at the 10 μg/kg/min dose. Minimal additional effect was observed at 30 minutes. Increased dose from 10 to 20 μ/kg/min resulted in small but significant (P < 0.05) additional reduction in pressures and increases in HR. No additional significant changes occurred at doses of 30 or 40, 4g/kg/min. Significant hemodynamic changes persisted for at least an hour (53 ± 3 min) after the phentolamine infusion was discontinued. Near maximal hemodynamic effects occur within 15 minutes of starting phentolamine infusion and can be achieved at doses of 10 to 20 Ag/kg/min. Increased HR during phentolamine infusion may limit its usefulness in patients with ischemic heart disease.