title: Effect of milrinone on short-term outcome of patients with myocardial dysfunction undergoing coronary artery bypass graft: A randomized controlled trial.
abstract: BACKGROUND
  Myocardial dysfunction needing inotropic support is a typical complication after on-pump cardiac surgery. In this study, we evaluate the effect of milrinone on patients with ventricular dysfunction undergoing coronary artery bypass graft (CABG).
  
  
  METHODS
  Seventy patients with impaired left ventricular function [left ventricular ejection fraction (LVEF) < 35%] undergoing on-pump CABG were enrolled. Patients were randomized to receive either an intraoperative bolus of milrinone (50 microg/kg) or saline as placebo followed by a 24-hour infusion of each agent (0.5 microg/kg/min). Hemodynamic parameters and transthoracic echocardiographic measurement of systolic and diastolic functions were the variables evaluated.
  
  
  RESULTS
  Serum levels of creatine phosphokinase (CPK), the MB isoenzyme of creatine kinase (CK-MB), occurrence of myocardial ischemia or infarction, and mean duration of using inotropic agents were significantly lower in the milrinone group (p < 0.05). There were no significant differences between the two groups regarding the development of ventricular arrhythmia, duration of cardiopulmonary bypass, intra-aortic balloon pump and inotropic support requirement, duration of mechanical ventilation, duration of intensive care unit stay and mortality rate. Although mean pre-operative LVEF was significantly lower in the milrinone group, there was no significant difference between post-operative LVEFs.
  
  
  CONCLUSIONS
  We suggest that perioperative administration of milrinone in patients undergoing on-pump CABG, especially those with low LVEF, is beneficial.
authors.affiliation: Cardiac Surgery Department, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Jebeli
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ghazinoor
authors.forename: Mohammad Hussein
authors.initials: MH
authors.lastname: Mandegar
authors.forename: Mohammad R
authors.initials: MR
authors.lastname: Rasouli
authors.forename: Payam
authors.initials: P
authors.lastname: Eghtesadi-Araghi
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Goodarzynejad
authors.forename: Robabeh
authors.initials: R
authors.lastname: Mohammadzadeh
authors.forename: Ali
authors.initials: A
authors.lastname: Darehzereshki
authors.forename: Saied
authors.initials: S
authors.lastname: Dianat
mesh_terms: D000368:Aged; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D001026:Coronary Artery Bypass; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood; D004334:Drug Administration Schedule; D004452:Echocardiography; D005260:Female; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D020105:Milrinone / Q000008:administration & dosage*; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000209:etiology; D019990:Perioperative Care; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*
chemical_list: D002316:Cardiotonic Agents; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form; D020105:Milrinone