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Titolo:
Hemodynamic effects of milrinone during weaning from cardiopulmonary bypass: Comparison of patients with a low and high prebypass cardiac index
Autore:
Yamada, T; Takeda, J; Katori, N; Tsuzaki, K; Ochiai, R;
Indirizzi:
Keio Univ, Sch Med, Dept Anesthesiol, Shinjuku Ku, Tokyo 1608582, Japan Keio Univ Tokyo Japan 1608582 thesiol, Shinjuku Ku, Tokyo 1608582, Japan
Titolo Testata:
JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA
fascicolo: 4, volume: 14, anno: 2000,
pagine: 367 - 373
SICI:
1053-0770(200008)14:4<367:HEOMDW>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONGESTIVE HEART-FAILURE; INTRAVENOUS MILRINONE; SURGERY; PHARMACOKINETICS; PHARMACOLOGY; INHIBITORS; EFFICACY;
Keywords:
milrinone; cardiac surgery; cardiopulmonary bypass; catecholamines; inotropes;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Yamada, T Keio Univ, Sch Med, Dept Anesthesiol, Shinjuku Ku, 35 Shinanomachi, Tokyo 1608582, Japan Keio Univ 35 Shinanomachi Tokyo Japan 1608582 yo 1608582, Japan
Citazione:
T. Yamada et al., "Hemodynamic effects of milrinone during weaning from cardiopulmonary bypass: Comparison of patients with a low and high prebypass cardiac index", J CARDIOTHO, 14(4), 2000, pp. 367-373

Abstract

Objective: To compare the hemodynamic effects of milrinone during weaning from cardiopulmonary bypass (CPB) in patients with a low pre-CPB cardiac index (Cl) <2.5 L/min/m(2)) and in patients with a high pre-CPB Cl (greater than or equal to 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 Cl/placebo, (2) low pre-CPB Cl/milrinone, (3) high pre-CPB Cl/placebo, and (4) high pre-CPB Cl/milrinone, Patients received a loading dose of 20 mu g/kg of milrinone followed by an infusion of 0.2 mu g/kg/min or placebo 15 minutes before the anticipated weaning time. Measurements and Main Results: In the low pre-CPB Cl/ placebo group, low Cls 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 hemody- namic support. Milrinone improved Cl and reduced SVR in the low pre-CPB Cl/milrinone group. Norepinephrine was needed to maintain an adequate systemic blood pressure in 6 of the12 patients, however. In the high pre-CPB Cl/placebo group, satisfactory Cia and SVRs were observed during weaning from CPB with low doses of dopamine and dobutamine. Milrinone significantly increased Cl and decreased SVR inthe high pre-CPB Cl/milrinone group: 10 of the 12 patients had Cls 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.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/07/20 alle ore 21:40:45