The effects of milrinone on hemodynamics in an experimental septic shock model.
OBJECTIVE
To investigate the specific hemodynamic effects of the phosphodiesterase inhibitor milrinone in a rabbit model of septic shock in the absence of any other treatment.


METHODS
A prospective, controlled, interventional study. Animal Model: Fourteen sedated New Zealand rabbits.


METHODS
Research laboratory of a health sciences university.


METHODS
Rabbits were anesthetized and vascular catheters inserted in femoral artery and jugular vein. After a stabilization period and the recording of baseline measurements (H0), all animals received a 10-mL infusion of Pseudomonas aeruginosa. Two hours later (H2rabbits were randomly assigned to receive 5% dextrose (control group) or milrinone (milrinone group).


RESULTS
Mean arterial blood pressure (MAP) was monitored continuously, and a cardiac index (CI) was determined every 30 mins by a transpulmonary thermodilution technique using an integrated monitoring device (PICCO). No differences were detected between the two groups after stabilization (H0) or before the treatment (H2) for either CI (mL/min(-1)/kg(-1)) or MAP (mm Hg). CI decreased progressively in the control group during the following 4 hrs, but not in the treated group (at H6: 122 +/- 4 vs. 207 +/- 16 mL/min(-1)/kg(-1); p < .05). No drop of MAP occurred after milrinone infusion. A comparison of the treated and control group reveals that milrinone improved tissue perfusion as evidenced by measurements of central venous saturation (at H4: 0.59 +/- 0.05 vs. 0.71 +/- 0.03, p = .04), lactacidemia (at H6: 10.3 +/- 2.4 vs. 3.9 +/- 0.9 mmol/L, p = .03), creatinemia (at H6: 95 +/- 11 vs. 60 +/- 5 micromol/L, p = .02) and survival (at H6: 5 vs. 7, not significant).


CONCLUSIONS
Milrinone improves cardiac output and tissue perfusion in a rabbit model involving severe septic shock.
Liet
Jean-Michel
JM
Pediatric Intensive Care Unit and the Department of Medical Biochemistry, University Hospital of Nantes, France.
Jacqueline
Cédric
C
Orsonneau
Jean-Luc
JL
Gras-Leguen
Christèle
C
Potel
Gilles
G
Rozé
Jean-Christophe
JC
D000818:Animals; D004108:Dilatation, Pathologic / Q000139:chemically induced; D004195:Disease Models, Animal; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D007022:Hypotension / Q000139:chemically induced; D020105:Milrinone / Q000009:adverse effects / Q000494:pharmacology*; D010101:Oxygen Consumption / Q000187:drug effects*; D010726:Phosphodiesterase Inhibitors / Q000009:adverse effects / Q000494:pharmacology*; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000503:physiopathology*; D011817:Rabbits; D011897:Random Allocation; D012772:Shock, Septic / Q000503:physiopathology*
D010726:Phosphodiesterase Inhibitors; D020105:Milrinone