Document Detail


Milrinone and low cardiac output following cardiac surgery in infants: is there a direct myocardial effect?
MedLine Citation:
PMID:  16193374     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We assessed the effect of milrinone on myocardial function in pediatric patients with postoperative low cardiac output syndrome by index of myocardial performance in a prospective, open-label, nonrandomized, consecutive study. Fifteen patients with low cardiac output syndrome following cardiac surgical treatment were studied in the tertiary cardiothoracic pediatric intensive care unit between April 2001 and November 2003 (age range, 0.2-16 months; median, 7; weight, 2.7-11.8 kg; median, 5). Echocardiographic, Doppler-derived, time interval-based index of myocardial performance (Tei index) was used to study cardiac function prior to and while on intravenous milrinone treatment for 18-24 hours. Treatment with milrinone led to improvement in biventricular myocardial function [mean right ventricular index from 0.521 (SD-0.213) to 0.385 (SD-0.215), p = 0.003; mean left ventricular index from 0.636 (SD-0.209) to 0.5 (SD-0.171), p = 0.012). No difference was found in the values of heart rate corrected right or left ventricular ejection time prior to and while on treatment with milrinone (right ventricle: mean, 1.23 (SD-0.42) and 1.14 (SD-0.48), p = 0.29; left ventricles: mean, 1.17 (SD-0.51) and 1.13 (SD-0.48), p = 0.66) Our data support the direct myocardial effect of milrinone as part of the mechanism behind its already proven benefit in children with low cardiac output syndrome following cardiac surgery.
Authors:
B Duggal; U Pratap; Z Slavik; J Kaplanova; D Macrae
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric cardiology     Volume:  26     ISSN:  0172-0643     ISO Abbreviation:  Pediatr Cardiol     Publication Date:    2005 Sep-Oct
Date Detail:
Created Date:  2005-12-26     Completed Date:  2006-03-28     Revised Date:  2008-02-20    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  642-5     Citation Subset:  IM    
Affiliation:
Paediatric Intensive Care Unit, Royal Brompton & Harefield NHS Trust, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK.
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MeSH Terms
Descriptor/Qualifier:
Cardiac Output, Low / etiology*,  physiopathology,  therapy*,  ultrasonography
Cardiac Surgical Procedures / adverse effects*
Cardiotonic Agents / administration & dosage,  therapeutic use*
Echocardiography, Doppler
Heart Rate / drug effects
Humans
Infant
Infusions, Intravenous
Milrinone / administration & dosage,  therapeutic use*
Myocardial Contraction / drug effects*
Prospective Studies
Stroke Volume / drug effects
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 78415-72-2/Milrinone

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


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