Abstract
Objective: To compare the hemodynamic effects of milrinone during weaning from cardiopulmonary bypass (CPB) in patients with a low pre-CPB cardiac index (CI) <2.5 L/min/m2) and in patients with a high pre-CPB CI (≥2.5 L/min/m2). Design: Prospective, randomized, double-blind study. Setting: University hospital. Participants: Forty-eight patients scheduled for elective coronary artery bypass graft surgery. Intervention: Patients were divided into 4 groups: (1) low pre-CPB CI/placebo, (2) low pre-CPB CI/milrinone, (3) high pre-CPB CI/placebo, and (4) high pre-CPB CI/milrinone. Patients received a loading dose of 20 μg/kg of milrinone followed by an infusion of 0.2 μg/kg/min or placebo 15 minutes before the anticipated weaning time. Measurements and Main Results: In the low pre-CPB CI/placebo group, low CIs and high systemic vascular resistances (SVRs) were observed after CPB. High doses of dopamine and dobutamine were needed, and infusion of epinephrine was used in 5 of the 12 patients for hemodynamic support. Milrinone improved CI and reduced SVR in the low pre-CPB CI/milrinone group. Norepinephrine was needed to maintain an adequate systemic blood pressure in 6 of the 12 patients, however. In the high pre-CPB CI/placebo group, satisfactory CIs and SVRs were observed during weaning from CPB with low doses of dopamine and dobutamine. Milrinone significantly increased CI and decreased SVR in the high pre-CPB CI/milrinone group: 10 of the 12 patients had CIs above the upper limit of normal, and 7 patients had SVRs below the lower limit of normal. Conclusion: Milrinone was effective during weaning from CPB in patients with a low pre-CPB CI. Milrinone in combination with norepinephrine was a good alternative to epinephrine for the treatment of myocardial dysfunction after CPB. Copyright (C) 2000 by W.B. Saunders Company.
| Original language | English |
|---|---|
| Pages (from-to) | 367-373 |
| Number of pages | 7 |
| Journal | Journal of Cardiothoracic and Vascular Anesthesia |
| Volume | 14 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2000 |
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Keywords
- Cardiac surgery
- Cardiopulmonary bypass
- Catecholamines
- Inotropes
- Milrinone
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Hemodynamic effects of milrinone during weaning from cardiopulmonary bypass : Comparison of patients with a low and high prebypass cardiac index. / Yamada, Tatsuya; Takeda, Junzo; Katori, Nobuyuki; Tsuzaki, Koichi; Ochiai, Ryoichi.
In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 14, No. 4, 2000, p. 367-373.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hemodynamic effects of milrinone during weaning from cardiopulmonary bypass
T2 - Comparison of patients with a low and high prebypass cardiac index
AU - Yamada, Tatsuya
AU - Takeda, Junzo
AU - Katori, Nobuyuki
AU - Tsuzaki, Koichi
AU - Ochiai, Ryoichi
PY - 2000
Y1 - 2000
N2 - Objective: To compare the hemodynamic effects of milrinone during weaning from cardiopulmonary bypass (CPB) in patients with a low pre-CPB cardiac index (CI) <2.5 L/min/m2) and in patients with a high pre-CPB CI (≥2.5 L/min/m2). Design: Prospective, randomized, double-blind study. Setting: University hospital. Participants: Forty-eight patients scheduled for elective coronary artery bypass graft surgery. Intervention: Patients were divided into 4 groups: (1) low pre-CPB CI/placebo, (2) low pre-CPB CI/milrinone, (3) high pre-CPB CI/placebo, and (4) high pre-CPB CI/milrinone. Patients received a loading dose of 20 μg/kg of milrinone followed by an infusion of 0.2 μg/kg/min or placebo 15 minutes before the anticipated weaning time. Measurements and Main Results: In the low pre-CPB CI/placebo group, low CIs and high systemic vascular resistances (SVRs) were observed after CPB. High doses of dopamine and dobutamine were needed, and infusion of epinephrine was used in 5 of the 12 patients for hemodynamic support. Milrinone improved CI and reduced SVR in the low pre-CPB CI/milrinone group. Norepinephrine was needed to maintain an adequate systemic blood pressure in 6 of the 12 patients, however. In the high pre-CPB CI/placebo group, satisfactory CIs and SVRs were observed during weaning from CPB with low doses of dopamine and dobutamine. Milrinone significantly increased CI and decreased SVR in the high pre-CPB CI/milrinone group: 10 of the 12 patients had CIs above the upper limit of normal, and 7 patients had SVRs below the lower limit of normal. Conclusion: Milrinone was effective during weaning from CPB in patients with a low pre-CPB CI. Milrinone in combination with norepinephrine was a good alternative to epinephrine for the treatment of myocardial dysfunction after CPB. Copyright (C) 2000 by W.B. Saunders Company.
AB - Objective: To compare the hemodynamic effects of milrinone during weaning from cardiopulmonary bypass (CPB) in patients with a low pre-CPB cardiac index (CI) <2.5 L/min/m2) and in patients with a high pre-CPB CI (≥2.5 L/min/m2). Design: Prospective, randomized, double-blind study. Setting: University hospital. Participants: Forty-eight patients scheduled for elective coronary artery bypass graft surgery. Intervention: Patients were divided into 4 groups: (1) low pre-CPB CI/placebo, (2) low pre-CPB CI/milrinone, (3) high pre-CPB CI/placebo, and (4) high pre-CPB CI/milrinone. Patients received a loading dose of 20 μg/kg of milrinone followed by an infusion of 0.2 μg/kg/min or placebo 15 minutes before the anticipated weaning time. Measurements and Main Results: In the low pre-CPB CI/placebo group, low CIs and high systemic vascular resistances (SVRs) were observed after CPB. High doses of dopamine and dobutamine were needed, and infusion of epinephrine was used in 5 of the 12 patients for hemodynamic support. Milrinone improved CI and reduced SVR in the low pre-CPB CI/milrinone group. Norepinephrine was needed to maintain an adequate systemic blood pressure in 6 of the 12 patients, however. In the high pre-CPB CI/placebo group, satisfactory CIs and SVRs were observed during weaning from CPB with low doses of dopamine and dobutamine. Milrinone significantly increased CI and decreased SVR in the high pre-CPB CI/milrinone group: 10 of the 12 patients had CIs above the upper limit of normal, and 7 patients had SVRs below the lower limit of normal. Conclusion: Milrinone was effective during weaning from CPB in patients with a low pre-CPB CI. Milrinone in combination with norepinephrine was a good alternative to epinephrine for the treatment of myocardial dysfunction after CPB. Copyright (C) 2000 by W.B. Saunders Company.
KW - Cardiac surgery
KW - Cardiopulmonary bypass
KW - Catecholamines
KW - Inotropes
KW - Milrinone
UR - http://www.scopus.com/inward/record.url?scp=0033900401&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033900401&partnerID=8YFLogxK
U2 - 10.1053/jcan.2000.7920
DO - 10.1053/jcan.2000.7920
M3 - Article
C2 - 10972598
AN - SCOPUS:0033900401
VL - 14
SP - 367
EP - 373
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
SN - 1053-0770
IS - 4
ER -