| Efficacy of pre-emptive milrinone in off-pump coronary artery bypass surgery: comparison between patients with a low and normal pre-graft cardiac index. | |
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MedLine Citation:
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PMID: 15450558 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The effect of pre-emptive milrinone without bolus during off-pump coronary artery bypass surgery (OPCAB) was evaluated in two groups of patients with low and normal pre-graft cardiac index. METHODS: Eighty-two patients were divided into two groups based on their pre-graft cardiac index. Each group was randomly subdivided into two groups to receive either milrinone or normal saline. After the internal mammary artery was harvested, the infusion of milrinone, or normal saline was started and maintained until the end of the anastomosis. The haemodynamic variables were measured: just before the start of milrinone or normal saline after pericardiotomy (baseline value); 10 min after the tissue stabilizer had been applied for the anastomosis of left anterior descending artery, left circumflex artery and right coronary artery; and after the sternal closure. RESULTS: Milrinone reduced the extent of the decrease in cardiac index and stroke volume as well as the extent of the increase in systemic and pulmonary vascular resistance. The extent of the decrease in cardiac index and mixed venous oxygen saturation were greater in normal pre-graft cardiac index group than in low pre-graft cardiac index group regardless of milrinone infusion during anastomoses. The effect of milrinone on haemodynamics showed no significant difference between low and normal pre-graft cardiac index groups. CONCLUSIONS: Pre-emptive milrinone infusion without bolus effectively improved cardiac performance during OPCAB and was especially useful for patients with low pre-graft cardiac index to prevent the decrease in cardiac index and stroke volume index below the critical level. |
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Authors:
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Y L Kwak; Y J Oh; S H Kim; H K Shin; J Y Kim; Y W Hong |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery Volume: 26 ISSN: 1010-7940 ISO Abbreviation: Eur J Cardiothorac Surg Publication Date: 2004 Oct |
Date Detail:
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Created Date: 2004-09-28 Completed Date: 2004-12-16 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: England |
Other Details:
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Languages: eng Pagination: 687-93 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology and Pain Medicine and Anesthesia and Pain Research Institute, Yonsei Cardiovascular Research Institute, Yonsei University School of Medicine, 134 Shinchon-Dong, Seodaemun-Gu, Seoul 120-752, South Korea. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiac Output / drug effects* Cardiopulmonary Bypass Cardiotonic Agents / therapeutic use* Female Hemodynamics / drug effects Humans Internal Mammary-Coronary Artery Anastomosis / methods* Intraoperative Care / methods Male Middle Aged Milrinone / therapeutic use* Monitoring, Intraoperative / methods |
| Chemical | |
Reg. No./Substance:
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0/Cardiotonic Agents; 78415-72-2/Milrinone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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