Intravenous milrinone in cardiac surgery.
Phosphodiesterase inhibitors including milrinone produce positive inotropic effects by slowing the hydrolysis of cyclic adenosine monophosphate in the myocardium. With a loading dose of 50 microg/kg followed by an infusion of 0.5 microg x kg(-1) x min(-1), milrinone increases stroke volume index and left ventricular velocity of circumferential fiber shortening after weaning from cardiopulmonary bypass. Milrinone has potential for the treatment and prevention of internal mammary artery spasm because of its vasodilative effect, which is similar to that of papaverine, and is a potent pulmonary vasodilator for patients with right ventricular dysfunction and pulmonary vasoconstriction. Low-dose milrinone may have antiinflammatory properties and potentially can improve splanchnic perfusion.
Levy
Jerrold H
JH
Division of Cardiothoracic Anesthesiology and Critical Care, Emory University School of Medicine and Emory Healthcare, Atlanta, Georgia, USA. jerrold_levy@emory.org
Bailey
James M
JM
Deeb
G Michael
GM
D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002316:Cardiotonic Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D006321:Heart / Q000187:drug effects*; D016027:Heart Transplantation; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D020105:Milrinone / Q000494:pharmacology* / Q000627:therapeutic use*; D010726:Phosphodiesterase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use*; D016276:Ventricular Function / Q000187:drug effects
D002316:Cardiotonic Agents; D010726:Phosphodiesterase Inhibitors; D020105:Milrinone