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A population pharmacokinetic analysis of milrinone in pediatric patients after cardiac surgery.

Abstract
The purpose of this study was to ascertain the optimal pharmacokinetic model for milrinone in pediatric patients after cardiac surgery when milrinone was administered as a slow loading dose followed by a constant-rate infusion. The data used for pharmacokinetic analysis were collected in a prospective, randomized, placebo-controlled multi-center trial of milrinone as prophylaxis for the development of low cardiac output syndrome after surgery for repair of complex congenital cardiac defects. Two blood samples were randomly collected from each patient for determination of plasma milrinone concentrations with subsequent population pharmacokinetic modeling. The pharmacokinetics of milrinone in pediatric patients under 6 year's age were best described by a weight-normalized one compartment model after a slow loading dose followed by a constant-rate infusion. The volume of distribution was 482 ml kg(-1) and was independent of age. Clearance was a linear function of age given by Cl = 2.42 ml kg(-1) min(-1) [1 + 0.396*age].
AuthorsJames M Bailey, Timothy M Hoffman, David L Wessel, David P Nelson, Andrew M Atz, Anthony C Chang, Thomas J Kulik, Thomas L Spray, Akbar Akbary, Richard P Miller, Gil Wernovsky
JournalJournal of pharmacokinetics and pharmacodynamics (J Pharmacokinet Pharmacodyn) Vol. 31 Issue 1 Pg. 43-59 (Feb 2004) ISSN: 1567-567X [Print] United States
PMID15346851 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Cardiotonic Agents
  • Milrinone
Topics
  • Age Factors
  • Cardiac Surgical Procedures
  • Cardiotonic Agents (administration & dosage, blood, pharmacokinetics)
  • Child, Preschool
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Humans
  • Infant
  • Infant, Newborn
  • Linear Models
  • Milrinone (administration & dosage, blood, pharmacokinetics)
  • Models, Biological
  • Postoperative Period
  • Prospective Studies
  • Randomized Controlled Trials as Topic
  • Time Factors

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