| Comparison of milrinone versus nitroglycerin, alone and in combination, on grafted internal mammary artery flow after cardiopulmonary bypass: effects of alpha-adrenergic stimulation. | |
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MedLine Citation:
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PMID: 11748520 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To compare changes in blood flow in a grafted internal mammary artery (IMA) after cardiopulmonary bypass (CPB) in response to the administration of milrinone or nitroglycerin and to establish the effects of alpha-adrenergic stimulation. DESIGN: Randomized study. SETTING: A university medical center hospital and a Veterans Affairs Medical Center hospital. PARTICIPANTS: Thirty consenting adults scheduled for elective coronary artery bypass graft surgery. INTERVENTIONS: Patients were randomized to receive a 2 microg/kg/min infusion of nitroglycerin (n = 10), a loading dose of 50 microg/kg of milrinone (n = 10), or both drugs combined (n = 10) shortly after CPB. Intravenous phenylephrine was administered to increase mean arterial pressure by 20%. IMA flow was measured with a calibrated laser Doppler flow probe. Hemodynamic and flow measurements were obtained before and after every intervention. MEASUREMENTS AND MAIN RESULTS: Nitroglycerin and milrinone increased mean IMA flow, but the increase was greater with milrinone. Both drugs combined were superior to nitroglycerin alone but not to milrinone. The addition of phenylephrine to nitroglycerin increased IMA flow in 6 of 10 patients. IMA flow decreased in 4 of 10 patients, however. Phenylephrine significantly increased IMA blood flow in patients receiving milrinone or in those given both drugs combined. CONCLUSION: After CPB, milrinone and nitroglycerin vasodilate the IMA; however, the combination of both drugs was not superior to milrinone alone. When using alpha-adrenergic stimulation, milrinone proved superior to nitroglycerin in preserving IMA flow. |
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Authors:
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E B Lobato; G M Janelle; F Urdaneta; T D Martin |
Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Journal of cardiothoracic and vascular anesthesia Volume: 15 ISSN: 1053-0770 ISO Abbreviation: J. Cardiothorac. Vasc. Anesth. Publication Date: 2001 Dec |
Date Detail:
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Created Date: 2001-12-18 Completed Date: 2002-01-17 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9110208 Medline TA: J Cardiothorac Vasc Anesth Country: United States |
Other Details:
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Languages: eng Pagination: 723-7 Citation Subset: IM |
Copyright Information:
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Copyright 2001 by W.B. Saunders Company |
Affiliation:
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Department of Anesthesiology, University of Florida College of Medicine, PO Box 100254, Gainesville, FL 32610-0254, USA. lobato@anest2.anest.ufl.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic alpha-Agonists
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pharmacology Blood Flow Velocity* Cardiopulmonary Bypass* Drug Therapy, Combination Hemodynamics / drug effects Humans Internal Mammary-Coronary Artery Anastomosis* Mammary Arteries / drug effects*, physiology, ultrasonography Milrinone / administration & dosage* Nitroglycerin / administration & dosage* Phenylephrine / pharmacology Phosphodiesterase Inhibitors / administration & dosage* Vasodilation / drug effects Vasodilator Agents / administration & dosage* |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic alpha-Agonists; 0/Phosphodiesterase Inhibitors; 0/Vasodilator Agents; 55-63-0/Nitroglycerin; 59-42-7/Phenylephrine; 78415-72-2/Milrinone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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