Document Detail


Dose-response effects of milrinone on hemodynamics of newborn pigs with hypoxia-reoxygenation.
MedLine Citation:
PMID:  18357438     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Neonatal asphyxia causes cardiogenic shock and pulmonary hypertension with decreased brain perfusion. We examined the dose-response of milrinone on systemic, pulmonary, and carotid circulations in a model of neonatal hypoxia-reoxygenation. DESIGN AND SETTING: Controlled, block-randomized study in a university research laboratory. SUBJECTS: Mixed breed piglets (1-3 days, 1.5-2.3 kg). INTERVENTIONS: In acutely instrumented piglets normocapnic alveolar hypoxia (10-15% oxygen) was induced for 2 h followed by reoxygenation with 100% oxygen (1 h) then 21% oxygen (3 h). At 2 h of reoxygenation after a volume loading (10 ml/kg) either saline or milrinone (bolus and infusion at 0.25, 0.5, or 0.75 microg/kg per minute) was given for 2 h in a blinded-randomized fashion (n = 7/group). MEASUREMENTS AND RESULTS: All milrinone-treated groups had higher cardiac output and stroke volume than those of saline-treated hypoxic controls, which showed progressive decline in these measurements. At 2 h of infusion plasma milrinone levels were significantly correlated with cardiac output (r = 0.6), which increased from pretreatment value in the group receiving 0.75 microg/kg per minute. Milrinone maintained mean arterial pressure; heart rate and pulmonary arterial pressure did not differ between groups. Milrinone prevented continued increases in systemic and pulmonary vascular resistances after hypoxia-reoxygenation. Milrinone infusion at higher doses increased common carotid flow. Milrinone-treated piglets had increased systemic and carotid oxygen delivery, with no difference in plasma and myocardial lactate levels among groups. CONCLUSIONS: When used to treat shock in newborn piglets with hypoxia-reoxygenation, milrinone improved cardiac output and carotid flow while maintaining systemic blood pressure. Pulmonary hypertension was not aggravated. Further studies are needed to confirm these findings in asphyxiated neonates.
Authors:
Chloë Joynt; David L Bigam; Gregory Charrois; Laurence D Jewell; Gregory Korbutt; Po-Yin Cheung
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-03-21
Journal Detail:
Title:  Intensive care medicine     Volume:  34     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-25     Completed Date:  2008-12-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1321-9     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
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MeSH Terms
Descriptor/Qualifier:
Animals
Animals, Newborn
Anoxia / drug therapy*
Blood Pressure / drug effects*
Dose-Response Relationship, Drug
Hemodynamics / drug effects*
Infusions, Intravenous
Lactates / blood
Milrinone / administration & dosage,  pharmacology,  therapeutic use*
Oxygen / administration & dosage
Swine
Vasodilator Agents / pharmacology,  therapeutic use*
Chemical
Reg. No./Substance:
0/Lactates; 0/Vasodilator Agents; 7782-44-7/Oxygen; 78415-72-2/Milrinone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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