Abstract | BACKGROUND: METHODS:
Milrinone was administered to 25 patients just before or immediately after separation from cardiopulmonary bypass. Arterial blood was sampled over the next 16 h and milrinone plasma concentrations were determined by high-performance liquid chromatography. Data were analyzed by extended nonlinear least-squares regression. The relation between milrinone plasma concentration and hemodynamic effect was examined in an additional 11 patients who had cardiac indices less than 2.5 l.min-1.m-2 immediately after separation from cardiopulmonary bypass. Milrinone was administered and plasma concentrations were related to changes in cardiac index during the next 10 min. RESULTS: A milrinone dose of 50 micrograms/kg in conjunction with an infusion of 0.5 micrograms.kg-1.min-1 consistently maintained plasma concentrations in excess of 100 ng/ml. A triexponential equation describing the plasma concentration as a function of time was used to describe the data. Central-compartment volume was 102 ml/kg, volume of distribution was 1,698 ml/kg, and elimination clearance was 1.88 ml.kg-1.min-1. Pharmacokinetic parameters were independent of dose. The relation between plasma concentration and percentage increase in cardiac index could be described by a sigmoidal curve with the plasma concentration associated with a 50% increase in cardiac index equal to 167 ng/ml. CONCLUSIONS: A milrinone dose of 50 micrograms/kg with an infusion at 0.5 micrograms.kg-1.min-1 maintains plasma concentrations at or above the threshold of therapeutic effects.
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Authors | J M Bailey, J H Levy, M Kikura, F Szlam, C C Hug Jr |
Journal | Anesthesiology
(Anesthesiology)
Vol. 81
Issue 3
Pg. 616-22
(Sep 1994)
ISSN: 0003-3022 [Print] United States |
PMID | 8092507
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Cardiotonic Agents
- Phosphodiesterase Inhibitors
- Pyridones
- Vasodilator Agents
- Milrinone
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Topics |
- Aged
- Body Fluid Compartments
- Cardiopulmonary Bypass
- Cardiotonic Agents
(blood, pharmacokinetics)
- Humans
- Infusions, Intravenous
- Middle Aged
- Milrinone
- Phosphodiesterase Inhibitors
(blood, pharmacokinetics)
- Pyridones
(blood, pharmacokinetics)
- Vasodilator Agents
(blood, pharmacokinetics)
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