Document Detail


Milrinone improves lung compliance in patients receiving mechanical ventilation for cardiogenic pulmonary edema.
MedLine Citation:
PMID:  12803589     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cardiogenic pulmonary edema is a frequent cause of respiratory failure. We investigated whether milrinone improved lung compliance. METHODS: We selected 10 patients with respiratory failure due to severe cardiogenic pulmonary edema to receive mechanical ventilation. Patients were administered a bolus injection of milrinone (50 microg kg-1) over 10 min, followed by continuous intravenous infusion (0.5 microg kg-1 min-1). Lung compliance, blood gas values, hemodynamic parameters, and sample plasma milrinone levels were assessed over 120 min after the onset of the continuous infusion of milrinone. RESULTS: Ten min following milrinone infusion, dynamic compliance (Cdyn) and static compliance (Cst) increased from 37 +/- 12 to 42 +/- 12 ml cmH2O-1 and from 40 +/- 13 to 45 +/- 12 ml cmH2O-1, respectively (P < 0.01). Plasma milrinone levels reached a therapeutic level for vasodilator and positive inotropic effect at 10 min after milrinone infusion. A significant decrease in mean pulmonary artery pressure and pulmonary artery wedge pressure occurred simultaneously with an increase in respiratory system compliance. However, an increase in cardiac index was observed later than these changes. There were significant correlations between the mean pulmonary artery pressure and Cdyn (r = -0.39, P < 0.01) and Cst (r = -0.38, P < 0.01). CONCLUSIONS: Milrinone-induced improvement in lung compliance along with an improvement of hemodynamics was found together with an inverse relationship between compliance and mean pulmonary artery pressure.
Authors:
S Takeda; J Matsumura; H Ikezaki; C Kim; N Sato; K Nakanishi; A Sakamoto; R Ogawa; K Tanaka
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  47     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-06-13     Completed Date:  2003-10-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  714-9     Citation Subset:  IM    
Affiliation:
Department of Intensive Care Medicine, Nippon Medical School, Tokyo, Japan. shinhiro@nms.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Gas Analysis
Female
Heart Failure / complications*,  physiopathology
Hemodynamics / physiology
Humans
Infusions, Intravenous
Lung Compliance / drug effects*
Male
Middle Aged
Milrinone / administration & dosage,  blood,  therapeutic use*
Pulmonary Edema / drug therapy*,  etiology,  physiopathology
Respiration, Artificial*
Respiratory Function Tests
Vasodilator Agents / administration & dosage,  blood,  therapeutic use*
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 78415-72-2/Milrinone
Comments/Corrections
Comment In:
Acta Anaesthesiol Scand. 2004 Apr;48(4):522; author reply 522   [PMID:  15025620 ]

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


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