Comparison of the hemodynamic effects of milrinone with dobutamine in patients after cardiac surgery
| Autor: | P.Stuart Withington, Kathy M. Sherry, R. O. Feneck, Amo Oduro-Dominah |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Male
Cardiac output medicine.medical_specialty Hypertension Pulmonary Cardiac index Cardiac Output Low Hemodynamics Intensive care Dobutamine medicine Humans Postoperative Period Cardiac Surgical Procedures business.industry Adrenergic beta-Agonists Middle Aged Cardiac surgery Anesthesiology and Pain Medicine Cardiothoracic surgery Anesthesia Milrinone Female Blood Gas Analysis Hypotension Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Journal of cardiothoracic and vascular anesthesia. 15(3) |
| ISSN: | 1053-0770 |
| Popis: | To compare the hemodynamic effects, efficacy, and safety of intravenous milrinone (M), 50 microg/kg during 10 minutes followed by 0.5 microg/kg/min, with intravenous dobutamine (D), 10 to 20 microg/kg/min, in patients with low cardiac output after cardiac surgery.Randomized, open-label, multicenter study.Cardiothoracic surgery departments, operating rooms, and intensive care units in 6 university hospitals.Patients (n = 120; 60 per group) after elective cardiac surgery.None.Analysis compared the hemodynamics at baseline and the percentage change from baseline during 4 hours of the drug infusion. The incidence of adverse events was recorded. Both groups had low mean (+/- SEM) cardiac indices (M, 1.6 ([0.03] L/min/m(2); D, 1.7 [0.03] L/min/m(2)) in association with adequate mean pulmonary capillary wedge pressures (M, 13.7 [1.3] mmHg; D, 12.7 [1.9] mmHg) at baseline. Group M had significantly higher systemic arterial pressures and systemic vascular resistances compared with group D; otherwise, the hemodynamics in both groups were comparable. During the study, hemodynamic responses included the following: group D had greater increases in cardiac index (at 1 hour, D = 55%, M = 36%; p0.01), heart rate (at 1 hour, D = 35%, M = 10%; p0.001), arterial pressures (mean arterial pressure at 1 hour, D = 31%, M = 7%; p0.001), and left ventricular stroke work index (at 1 hour, D = 75%, M = 45%; p0.05). Group M had greater decreases in mean pulmonary capillary wedge pressure (at 1 hour, D = -3%, M = -14%; p0.05). Comparisons of adverse events showed that dobutamine was associated with a higher incidence of hypertension (D = 40%, M = 13%; p0.02) and change of rhythm from sinus to atrial fibrillation (D = 18%, M = 5%; p0.04). Milrinone was associated with a higher incidence of sinus bradycardia (D = 2%, M = 13%; p0.03).Milrinone and dobutamine are appropriate and comparable for the pharmacologic treatment of the low- output syndrome after cardiopulmonary bypass. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect