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The effect of milrinone on hemodynamics and left ventricular function after emergence from cardiopulmonary bypass.

Publication ,  Journal Article
Kikura, M; Levy, JH; Michelsen, LG; Shanewise, JS; Bailey, JM; Sadel, SM; Szlam, F
Published in: Anesth Analg
July 1997

Although milrinone effectively increases cardiac function, few studies have specifically evaluated its efficacy during cardiac surgery. We investigated the effects of milrinone on hemodynamics and left ventricular function in cardiac surgical patients who were already treated with catecholamines. Thirty-seven patients undergoing cardiac surgery were studied. Immediately after emergence from cardiopulmonary bypass (CPB), patients were randomly assigned to a control group (n = 10) or to one of these milrinone groups: milrinone 50 microg/kg intravenously (n = 8), 50 microg/kg + 0.5 microg x kg(-1) x min(-1) (n = 10), or 75 microg/kg + 0.75 microg x kg(-1) x min(-1) (n = 9). Hemodynamics and transesophageal echocardiogram were recorded while constant filling pressures were maintained by volume reinfusion from the CPB reservoir. Arterial blood samples were obtained for the measurement of milrinone plasma concentrations and to determine the dose response curve. In all three milrinone groups, cardiac index and velocity of circumferential fiber shortening (Vcfc) significantly increased from the baseline, and both were significantly higher at 5 and 10 min than those in the control group. The plasma concentration of milrinone with half of maximum increase in Vcfc was 139.3 ng/mL based on the dose-response curve. Thus, milrinone improves hemodynamics and left ventricular function when constant loading conditions are maintained.

Duke Scholars

Published In

Anesth Analg

DOI

ISSN

0003-2999

Publication Date

July 1997

Volume

85

Issue

1

Start / End Page

16 / 22

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Pyridones
  • Milrinone
  • Middle Aged
  • Male
  • Injections, Intravenous
  • Infusions, Intravenous
  • Humans
  • Hemodynamics
  • Female
 

Citation

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Kikura, M., Levy, J. H., Michelsen, L. G., Shanewise, J. S., Bailey, J. M., Sadel, S. M., & Szlam, F. (1997). The effect of milrinone on hemodynamics and left ventricular function after emergence from cardiopulmonary bypass. Anesth Analg, 85(1), 16–22. https://doi.org/10.1097/00000539-199707000-00004
Kikura, M., J. H. Levy, L. G. Michelsen, J. S. Shanewise, J. M. Bailey, S. M. Sadel, and F. Szlam. “The effect of milrinone on hemodynamics and left ventricular function after emergence from cardiopulmonary bypass.Anesth Analg 85, no. 1 (July 1997): 16–22. https://doi.org/10.1097/00000539-199707000-00004.
Kikura M, Levy JH, Michelsen LG, Shanewise JS, Bailey JM, Sadel SM, et al. The effect of milrinone on hemodynamics and left ventricular function after emergence from cardiopulmonary bypass. Anesth Analg. 1997 Jul;85(1):16–22.
Kikura, M., et al. “The effect of milrinone on hemodynamics and left ventricular function after emergence from cardiopulmonary bypass.Anesth Analg, vol. 85, no. 1, July 1997, pp. 16–22. Pubmed, doi:10.1097/00000539-199707000-00004.
Kikura M, Levy JH, Michelsen LG, Shanewise JS, Bailey JM, Sadel SM, Szlam F. The effect of milrinone on hemodynamics and left ventricular function after emergence from cardiopulmonary bypass. Anesth Analg. 1997 Jul;85(1):16–22.

Published In

Anesth Analg

DOI

ISSN

0003-2999

Publication Date

July 1997

Volume

85

Issue

1

Start / End Page

16 / 22

Location

United States

Related Subject Headings

  • Ventricular Function, Left
  • Pyridones
  • Milrinone
  • Middle Aged
  • Male
  • Injections, Intravenous
  • Infusions, Intravenous
  • Humans
  • Hemodynamics
  • Female