Renal Dysfunction and Arrhythmia Association in Patients Receiving Milrinone After Cardiac Surgery.

Autor: Valkovec AM; Department of Pharmacy, Duke University Hospital, Durham, NC. Electronic address: amy.valkovec@duke.edu., Kram SJ; Department of Pharmacy, Duke University Hospital, Durham, NC., Henderson JB; Department of Pharmacy, Duke University Hospital, Durham, NC., Levy JH; Departments of Critical Care and Surgery (Cardiothoracic) Duke University Hospital, Duke University, Durham, NC.
Jazyk: angličtina
Zdroj: Journal of cardiothoracic and vascular anesthesia [J Cardiothorac Vasc Anesth] 2023 Mar; Vol. 37 (3), pp. 353-359. Date of Electronic Publication: 2022 Nov 25.
DOI: 10.1053/j.jvca.2022.11.027
Abstrakt: Objective: The altered pharmacokinetics of milrinone in renal impairment could result in an increased risk of cardiac arrhythmias. This study aimed to determine if there is an association between new-onset arrhythmias and renal impairment after cardiac surgery following milrinone administration.
Design: A retrospective cohort study.
Setting: A single-center tertiary care hospital.
Participants: Adult patients who received a milrinone infusion in the intensive care unit (ICU) setting after coronary artery bypass graft, valvuloplasty, annuloplasty, or a combination of these surgeries from July 1, 2014 to July 1, 2021. Renal impairment was defined using a creatinine clearance <60 mL/min, calculated using the Cockcroft-Gault equation.
Interventions: Patients received a weight-based continuous intravenous infusion of milrinone.
Measurements and Main Results: The primary outcome was the presence of new arrhythmias after the initial administration of a weight-based continuous intravenous infusion of milrinone postcardiac surgery. Of the 197 patients who met inclusion, there was no difference in the presence of new arrhythmias (42.9% v 40.3%, p = 0.76) or in the time to first new arrhythmia from milrinone initiation in those with renal impairment compared to those without renal impairment (29.1 hours v 33.3 hours, p = 0.54). Patients with renal impairment had a longer hospital stay than patients without renal impairment (17.5 days v 13.9 days, p = 0.016). Arrhythmia type, length of ICU stay, ICU mortality, and hospital mortality were not different between the cohorts.
Conclusions: There was no association between new arrhythmias, milrinone, and renal impairment in patients postcardiac surgery.
Competing Interests: Conflict of Interest None.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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