title: Milrinone is preferred to levosimendan for mesenteric perfusion in hypoxia-reoxygenated newborn piglets treated with dopamine.
abstract: BACKGROUND
  There is little information regarding the comparative hemodynamic effects of adding milrinone or levosimendan to dopamine infusion in hypoxia-reoxygenated (H-R) newborns.
  
  
  RESULTS
  Severely hypoxic piglets had cardiogenic shock with depressed cardiac index (CI) and mean arterial pressure (MAP). The hemodynamics deteriorated gradually after initial recovery upon reoxygenation. Heart rate and CI improved with milrinone (D+M) and levosimendan (D+L) administration (P < 0.05 vs. control). Both regimens improved carotid arterial flow and carotid vascular resistance; D+M additionally improved superior mesentric arterial flow (all P < 0.05 vs. control). No effect was found on renal arterial flow or elevated lactate state with either regimen. D+M piglets also had a lower myocardial oxidized/reduced glutathione ratio (P < 0.05 vs. control).
  
  
  CONCLUSIONS
  In conclusion, adding milrinone or levosimendan to dopamine similarly improved systemic hemodynamics in H-R newborn piglets. Milrinone also improved mesenteric perfusion and attenuated myocardial oxidative stress.
  
  
  METHODS
  Twenty-eight piglets (1-4 d, 1.5-2.5 kg) were instrumented for continuous monitoring of systemic MAP and pulmonary arterial pressure (PAP), CI, and carotid, superior mesenteric, and renal arterial flows. Piglets were randomized with blinding to sham-operated, H-R control (saline), and H-R dopamine (10 μg/kg/min) with D+M or D+L groups. H-R piglets underwent H-R followed by 2 h of drug infusion after reoxygenation. Tissue was collected for biochemical/oxidative stress testing and histological analysis.
authors.affiliation: Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Namdar
authors.initials: N
authors.lastname: Manouchehri
authors.forename: David L
authors.initials: DL
authors.lastname: Bigam
authors.forename: Thomas
authors.initials: T
authors.lastname: Churchill
authors.forename: Chloe
authors.initials: C
authors.lastname: Joynt
authors.forename: Maximo
authors.initials: M
authors.lastname: Vento
authors.forename: Po-Yin
authors.initials: PY
authors.lastname: Cheung
mesh_terms: D000818:Animals; D000831:Animals, Newborn / Q000502:physiology*; D002316:Cardiotonic Agents / Q000494:pharmacology / Q000627:therapeutic use; D004298:Dopamine / Q000494:pharmacology / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006835:Hydrazones / Q000494:pharmacology / Q000627:therapeutic use*; D000860:Hypoxia / Q000188:drug therapy*; D008638:Mesenteric Arteries / Q000187:drug effects; D020105:Milrinone / Q000494:pharmacology / Q000627:therapeutic use*; D023421:Models, Animal; D015425:Myocardial Reperfusion / Q000379:methods*; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D018384:Oxidative Stress / Q000187:drug effects / Q000502:physiology; D011724:Pyridazines / Q000494:pharmacology / Q000627:therapeutic use*; D000077464:Simendan; D013552:Swine; D014665:Vasodilator Agents / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D014665:Vasodilator Agents; D000077464:Simendan; D020105:Milrinone; D004298:Dopamine