Effect of milrinone on short-term outcome of patients with myocardial dysfunction undergoing coronary artery bypass graft: A randomized controlled trial.

Abstract

BACKGROUND:

Myocardial dysfunction needing inotropic support is a typical complication after on-pump cardiac surgery. In this study, we evaluate the effect of milrinone on patients with ventricular dysfunction undergoing coronary artery bypass graft (CABG).

METHODS:

Seventy patients with impaired left ventricular function [left ventricular ejection fraction (LVEF) < 35%] undergoing on-pump CABG were enrolled. Patients were randomized to receive either an intraoperative bolus of milrinone (50 microg/kg) or saline as placebo followed by a 24-hour infusion of each agent (0.5 microg/kg/min). Hemodynamic parameters and transthoracic echocardiographic measurement of systolic and diastolic functions were the variables evaluated.

RESULTS:

Serum levels of creatine phosphokinase (CPK), the MB isoenzyme of creatine kinase (CK-MB), occurrence of myocardial ischemia or infarction, and mean duration of using inotropic agents were significantly lower in the milrinone group (p < 0.05). There were no significant differences between the two groups regarding the development of ventricular arrhythmia, duration of cardiopulmonary bypass, intra-aortic balloon pump and inotropic support requirement, duration of mechanical ventilation, duration of intensive care unit stay and mortality rate. Although mean pre-operative LVEF was significantly lower in the milrinone group, there was no significant difference between post-operative LVEFs.

CONCLUSIONS:

We suggest that perioperative administration of milrinone in patients undergoing on-pump CABG, especially those with low LVEF, is beneficial.

• Authors: Mohammad Jebeli, Mohammad Ghazinoor, Mohammad Hussein Mandegar, Mohammad R Rasouli, Payam Eghtesadi-Araghi, Hamidreza Goodarzynejad, Robabeh Mohammadzadeh, Ali Darehzereshki, Saied Dianat
• Journal: Cardiology journal (Cardiol J) Vol. 17 Issue 1 Pg. 73-8 ( 2010) ISSN: 1898-018X [Electronic] Poland
• PMID: 20104460 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Cardiotonic Agents
• Creatine Kinase
• Creatine Kinase, MB Form
• Milrinone

Topics

• Aged
• Cardiotonic Agents (administration & dosage)
• Coronary Artery Bypass
• Creatine Kinase (blood)
• Creatine Kinase, MB Form (blood)
• Drug Administration Schedule
• Echocardiography
• Female
• Humans
• Incidence
• Infusions, Intravenous
• Injections, Intravenous
• Male
• Middle Aged
• Milrinone (administration & dosage)
• Myocardial Infarction (epidemiology, etiology)
• Myocardial Ischemia (epidemiology, etiology)
• Perioperative Care
• Stroke Volume
• Time Factors
• Treatment Outcome
• Ventricular Dysfunction, Left (diagnostic imaging, drug therapy, physiopathology, surgery)