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https://www.readbyqxmd.com/read/28099979/milrinone-pharmacokinetics-and-pharmacodynamics-in-neonates-with-persistent-pulmonary-hypertension-of-the-newborn
#1
Annie Giaccone, Athena F Zuppa, Beena Sood, Meryl S Cohen, Michael L O'Byrne, Ganesh Moorthy, Amit Mathur, Haresh Kirpalani
Objective To describe the pharmacokinetics and pharmacodynamics of milrinone in infants with persistent pulmonary hypertension of the newborn (PPHN) and to explore the impact of age on milrinone disposition. Design Randomized, open label pilot study. Setting Multicenter; level 3 and level 4 neonatal intensive care units. Patients Six infants ≥34 weeks' gestational age and <10 days of life with persistent hypoxemia receiving inhaled nitric oxide. Intervention Intravenous milrinone lactate in one of two dosing regimens: (1) low dose, 20 mcg/kg bolus followed by 0...
January 18, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28069456/neurocardiac-protection-with-milrinone-for-restoring-acute-cerebral-hypoperfusion-and-delayed-ischemic-injury-after-experimental-subarachnoid-hemorrhage
#2
Tomoko Mutoh, Tatsushi Mutoh, Kazumasu Sasaki, Kazuhiro Nakamura, Yasuko Tatewaki, Tatsuya Ishikawa, Yasuyuki Taki
BACKGROUND AND PURPOSE: Acute cerebral hypoperfusion following subarachnoid hemorrhage (SAH) is highly related to the pathogenesis of delayed cerebral ischemia (DCI), but the therapeutic option is poorly available. This study aimed to clarify the effect of milrinone (MIL) on cerebral blood flow (CBF) and related outcomes after experimental SAH. METHODS: Twenty-seven male C57BL/6 mice were assigned to either sham surgery (SAH-sham; n=6), SAH induced by endovascular perforation (control; n=10), or SAH followed by cardiac support with intravenous MIL (n=11) performed 1...
January 6, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28060152/an-elevated-low-cardiac-output-syndrome-score-is-associated-with-morbidity-in-infants-after-congenital-heart-surgery
#3
Kalia P Ulate, Ofer Yanay, Howard Jeffries, Harris Baden, Jane L Di Gennaro, Jerry Zimmerman
OBJECTIVES: To evaluate an empirically derived Low Cardiac Output Syndrome Score as a clinical assessment tool for the presence and severity of Low Cardiac Output Syndrome and to examine its association with clinical outcomes in infants who underwent surgical repair or palliation of congenital heart defects. DESIGN: Prospective observational cohort study. SETTING: Cardiac ICU at Seattle Children's Hospital. PATIENTS: Infants undergoing surgical repair or palliation of congenital heart defects...
January 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28008646/acute-cardiac-support-with-intravenous-milrinone-promotes-recovery-from-early-brain-injury-in-a-murine-model-of-severe-subarachnoid-hemorrhage
#4
Tomoko Mutoh, Tatsushi Mutoh, Kazuhiro Nakamura, Yukiko Yamamoto, Yoshiharu Tsuru, Hirokazu Tsubone, Tatsuya Ishikawa, Yasuyuki Taki
Early brain injury/ischemia (EBI) is a serious complication early after subarachnoid hemorrhage (SAH) that contributes to development of delayed cerebral ischemia (DCI). This study aimed to determine the role of inotropic cardiac support using milrinone (MIL) on restoring acute cerebral hypoperfusion attributable to EBI and improving outcomes after experimental SAH. Forty-three male C57BL/6 mice were assigned to either sham surgery (SAH-sham), SAH induced by endovascular perforation plus postconditioning with 2% isoflurane (Control), or SAH plus isoflurane combined with MIL with and without hypoxia-inducible factor inhibitor (HIF-I) pretreatment...
December 23, 2016: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/27975297/cump-hydrolysis-by-pde3a
#5
Stefan Berrisch, Jessica Ostermeyer, Volkhard Kaever, Solveig Kälble, Denise Hilfiker-Kleiner, Roland Seifert, Erich H Schneider
As previously reported, the cardiac phosphodiesterase PDE3A hydrolyzes cUMP. Moreover, cUMP-degrading activity was detected in cow and dog hearts several decades ago. Our aim was to characterize the enzyme kinetic parameters of PDE3A-mediated cUMP hydrolysis and to investigate whether cUMP and cUMP-hydrolyzing PDEs are present in cardiomyocytes. PDE3A-mediated cUMP hydrolysis was characterized in time course, inhibitor, and Michaelis-Menten kinetics experiments. Intracellular cyclic nucleotide (cNMP) concentrations and the mRNAs of cUMP-degrading PDEs were quantitated in neonatal rat cardiomyocytes (NRCMs) and murine HL-1 cardiomyogenic cells...
December 14, 2016: Naunyn-Schmiedeberg's Archives of Pharmacology
https://www.readbyqxmd.com/read/27842615/the-use-of-milrinone-in-patients-with-delayed-cerebral-ischemia-following-subarachnoid-hemorrhage-a-systematic-review
#6
Marcelo Lannes, Frederick Zeiler, Céline Guichon, Jeanne Teitelbaum
OBJECTIVE: The purpose of this article is to provide a systematic review of the evidence supporting the use of milrinone for the management of delayed cerebral ischemia (DCI) following subarachnoid hemorrhage (SAH). DESIGN: Primary outcomes were functional neurological status and the incidence of cerebral infarction. Search strategies adapted to the different databases were developed by a professional librarian. Medline, EMBASE, the Cochrane Library database, Web of Science, SCOPUS, BIOSIS, Global Health, Health Star, Open SIGLE, Google Scholar and the New York Academy of Medicine Gray Literature were searched as well as clinical trials databases and the proceedings of several scientific meetings...
November 15, 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/27826325/enterovirus-71-infection-and-neurological-complications
#7
REVIEW
Kyung Yeon Lee
Since the outbreak of the enterovirus 71 (EV71) infection in Malaysia in 1997, large epidemics of EV71 have occurred in the Asia-Pacific region. Many children and infants have died from serious neurological complications during these epidemics, and EV71 infection has become a serious public health problem in these areas. EV71 infection causes hand, foot and mouth disease (HFMD) in children, and usually resolves spontaneously. However, EV71 occasionally involves the central nervous system (CNS), and induces diverse neurological complications such as brainstem encephalitis, aseptic meningitis, and acute flaccid paralysis...
October 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/27826160/pharmacy-support-of-a-pediatric-patient-receiving-milrinone-at-home
#8
Ariel Xue, Deonne Dersch-Mills, Clara Tsang, Steven C Greenway
No abstract text is available yet for this article.
September 2016: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/27806964/phosphodiesterase-inhibitor-based-vasodilation-improves-oxygen-delivery-and-clinical-outcomes-following-stage-1-palliation
#9
Kimberly I Mills, Aditya K Kaza, Brian K Walsh, Hilary C Bond, Mackenzie Ford, David Wypij, Ravi R Thiagarajan, Melvin C Almodovar, Luis G Quinonez, Christopher W Baird, Sitaram E Emani, Frank A Pigula, James A DiNardo, John N Kheir
BACKGROUND: Systemic vasodilation using α-receptor blockade has been shown to decrease the incidence of postoperative cardiac arrest following stage 1 palliation (S1P), primarily when utilizing the modified Blalock-Taussig shunt. We studied the effects of a protocol in which milrinone was primarily used to lower systemic vascular resistance (SVR) following S1P using the right ventricular to pulmonary artery shunt, measuring its effects on oxygen delivery (DO2) profiles and clinical outcomes...
November 2, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27756610/promising-approach-for-the-preclinical-assessment-of-cardiac-risks-using-left-ventricular-pressure-volume-loop-analyses-in-anesthetized-monkeys
#10
Tomomichi Ishizaka, Yu Yoshimatsu, Yu Maeda, Wataru Takasaki, Katsuyoshi Chiba, Kazuhiko Mori
INTRODUCTION: Load-independent cardiac parameters obtained from the ventricular pressure-volume relationship are recognized as gold standard indexes for evaluating cardiac inotropy. In this study, for better analyses of cardiac risks, load-independent pressure-volume loop parameters were assessed in addition to load-dependent inotropic, hemodynamic and electrocardiographic changes in isoflurane-anesthetized monkeys. METHODS: The animals were given milrinone (a PDE 3 inhibitor), metoprolol (a β-blocker), or dl-sotalol (a β+IKr blocker) intravenously over 10min at two dose levels including clinically relevant doses (n=5/drug)...
October 15, 2016: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/27741040/citric-acid-cycle-metabolites-predict-the-severity-of-myocardial-stunning-and-mortality-in-newborn-pigs
#11
Janus Adler Hyldebrandt, Nicolaj Brejnholt Støttrup, Christian Alcaraz Frederiksen, Johan Heiberg, Rune Isak Dupont Birkler, Mogens Johannsen, Michael Rahbek Schmidt, Hanne Berg Ravn
OBJECTIVES: Myocardial infarction and chronic heart failure induce specific metabolic changes in the neonatal myocardium that are closely correlated to outcome. The aim of this study was to examine the metabolic responses to noninfarct heart failure and inotropic treatments in the newborn heart, which so far are undetermined. DESIGN: A total of 28 newborn pigs were instrumented with a microdialysis catheter in the right ventricle, and intercellular citric acid cycle intermediates and adenosine metabolite concentrations were determined at 20-minute intervals...
December 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27720291/impact-of-milrinone-administration-in-adult-cardiac-surgery-patients-updated-meta-analysis
#12
Masahiro Ushio, Moritoki Egi, Junji Wakabayashi, Taichi Nishimura, Yuji Miyatake, Norihiko Obata, Satoshi Mizobuchi
OBJECTIVE: To determine the effects of milrinone on short-term mortality in cardiac surgery patients with focus on the presence or absence of heterogeneity of the effect. DESIGN: A systematic review and meta-analysis. SETTING AND PARTICIPANTS: Five hundred thirty-seven adult cardiac surgery patients from 12 RCTs. INTERVENTIONS: Milrinone administration. MEASUREMENTS AND MAIN RESULTS: The authors conducted a systematic Medline and Pubmed search to assess the effect of milrinone on short-term mortality in adult cardiac surgery patients...
December 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27688917/compartment-syndrome-as-a-result-of-systemic-capillary-leak-syndrome
#13
Kwadwo Kyeremanteng, Gianni D'Egidio, Cynthia Wan, Alan Baxter, Hans Rosenberg
Objective. To describe a single case of Systemic Capillary Leak Syndrome (SCLS) with a rare complication of compartment syndrome. Patient. Our patient is a 57-year-old male, referred to our hospital due to polycythemia (hemoglobin (Hgb) of 220 g/L), hypotension, acute renal failure, and bilateral calf pain. Measurements and Main Results. The patient required bilateral forearm, thigh, and calf fasciotomies during his ICU stay and continuous renal replacement therapy was instituted following onset of acute renal failure and oliguria...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27610349/single-institution-experience-with-the-ladd-s-procedure-in-patients-with-heterotaxy-and-stage-i-palliated-single-ventricle
#14
Kurt D Piggott, Grace George, Harun Fakioglu, Carlos Blanco, Sukumar Saguna Narasimhulu, Kamal Pourmoghadam, Hamish Munroe, William Decampli
AIM: To investigate and describe our current institutional management protocol for single-ventricle patients who must undergo a Ladd's procedure. METHODS: We retrospectively reviewed the charts of all patients from January 2005 to March 2014 who were diagnosed with heterotaxy syndrome and an associated intestinal rotation anomaly who carried a cardiac diagnosis of functional single ventricle and were status post stage I palliation. A total of 8 patients with a history of stage I single-ventricle palliation underwent Ladd's procedure during this time period...
August 8, 2016: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/27571932/b-type-natriuretic-peptide-modulates-pulmonary-vein-arrhythmogenesis-a-novel-potential-contributor-to-the-genesis-of-atrial-tachyarrhythmia-in-heart-failure
#15
Yung-Kuo Lin, Yao-Chang Chen, Yi-Ann Chen, Yung-Hsin Yeh, Shih-Ann Chen, Yi-Jen Chen
BACKGROUND: Heart failure (HF) plays a critical role in the genesis of atrial fibrillation (AF). A high B-type natriuretic peptide (BNP) level occurs in patients with HF and in patients with AF. However, the role of BNP in the pathophysiology of AF is not clear. The purposes of this study were to evaluate the effects of BNP on pulmonary vein (PV) arrhythmogenesis. METHODS AND RESULTS: Whole-cell patch clamp and fluorescence were used to study the action potential, ionic currents, and calcium homeostasis in isolated single rabbit PV cardiomyocytes before and after a BNP infusion, with or without ODQ (10 μM), milrinone (50 μM), or ouabain (1 μM)...
December 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27535714/a-case-of-refractory-heart-failure-in-becker-muscular-dystrophy-improved-with-corticosteroid-therapy
#16
Makiko Nakamura, Osahiko Sunagawa, Ryo Hokama, Hiroyuki Tsuchiya, Takafumi Miyara, Yoji Taba, Takashi Touma
The patient was a 26 year-old man who was referred to our hospital in June 2011 because of severe heart failure. At age 24 years, he was found to have Becker muscular dystrophy. He received enalapril for cardiac dysfunction; however, he had worsening heart failure and was thus referred to our hospital. Echocardiography showed enlargement of the left ventricle, with a diastolic dimension of 77 mm and ejection fraction of 19%. His condition improved temporarily after an infusion of dobutamine and milrinone. He was then administered amiodarone for ventricular tachycardia; however, he subsequently developed hemoptysis...
September 28, 2016: International Heart Journal
https://www.readbyqxmd.com/read/27501717/current-therapeutic-drugs-against-cerebral-vasospasm-after-subarachnoid-hemorrhage-a-comprehensive-review-of-basic-and-clinical-studies
#17
Shu Hasegawa, Yu Hasegawa, Masaki Miura
BACKGROUND: Cerebral vasospasm (CVS) is well known as a major complication in subarachnoid hemorrhage (SAH) patients, and research has long been focused on improving morbidity and mortality. As CVS commonly develops from day 4 to day 14 after SAH onset, SAH patients require therapies with drugs for preventing CVS after surgical treatment for the source of hemorrhage, mostly ruptured intracranial aneurysms. It is thought that the pathogenesis of CVS is initiated by prolonged smooth muscle contraction, and the subsequent hypoperfusion and cytotoxic responses induce cerebral ischemia...
August 8, 2016: Current Drug Delivery
https://www.readbyqxmd.com/read/27500723/inotropic-therapy-in-newborns-a-population-based-national-registry-study
#18
Margrete Larsen Burns, Hans Jørgen Stensvold, Kari Risnes, Hans Jørgen Guthe, Henriette Astrup, S Marianne Nordhov, Terje Reidar Selberg, Arild Rønnestad, Astri Maria Lang
OBJECTIVE: To describe the use of inotropic drugs and the characteristics of neonates receiving such treatment in a national cohort of patients admitted to neonatal ICUs in Norway. DESIGN: A national registry study of patients included in the Norwegian Neonatal Network database 2009-2014. Demographic and treatment data, including the use of inotropic drugs (dopamine, dobutamine, epinephrine, norepinephrine, milrinone, and levosimendan) and outcomes, were retrieved and analyzed...
October 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27490706/dosing-of-milrinone-in-preterm-neonates-to-prevent-postligation-cardiac-syndrome-simulation-study-suggests-need-for-bolus-infusion
#19
Maarja Hallik, Tõnis Tasa, Joel Starkopf, Tuuli Metsvaht
BACKGROUND: Milrinone has been suggested as a possible first-line therapy for preterm neonates to prevent postligation cardiac syndrome (PLCS) through decreasing systemic vascular resistance and increasing cardiac contractility. The optimal dosing regimen, however, is not known. OBJECTIVE: To model the dosing of milrinone in preterm infants for prevention of PLCS after surgical closure of patent ductus arteriosus (PDA). METHODS: Milrinone time-concentration profiles were simulated for 1,000 subjects using the volume of distribution and clearance estimates based on one compartmental population pharmacokinetic model by Paradisis et al...
2017: Neonatology
https://www.readbyqxmd.com/read/27473721/inhaled-milrinone-for-pulmonary-hypertension-in-high-risk-cardiac-surgery-silver-bullet-or-just-part-of-a-broader%C3%A2-management-strategy
#20
EDITORIAL
Joseph Bednarczyk, Johann Strumpher, Eric Jacobsohn
No abstract text is available yet for this article.
October 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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