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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
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...
October 12, 2016: Pediatric Critical Care Medicine
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...
July 21, 2016: Journal of Cardiothoracic and Vascular Anesthesia
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
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
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)...
August 30, 2016: Journal of Cardiovascular Electrophysiology
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
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
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
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...
August 5, 2016: Neonatology
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
André Y Denault, Jean S Bussières, Ramiro Arellano, Barry Finegan, Paul Gavra, François Haddad, Anne Q N Nguyen, France Varin, Annik Fortier, Sylvie Levesque, Yanfen Shi, Mahsa Elmi-Sarabi, Jean-Claude Tardif, Louis P Perrault, Jean Lambert
PURPOSE: Inhaled milrinone (iMil) has been used for the treatment of pulmonary hypertension (PH) but its efficacy, safety, and prophylactic effects in facilitating separation from cardiopulmonary bypass (CPB) and preventing right ventricular (RV) dysfunction have not yet been evaluated in a clinical trial. The purpose of this study was to investigate if iMil administered before CPB would be superior to placebo in facilitating separation from CPB. METHODS: High-risk cardiac surgical patients with PH were randomized to receive iMil or placebo after the induction of anesthesia and before CPB...
October 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Abhishek Jaiswal, Vinh Q Nguyen, Thierry H Le Jemtel, Keith C Ferdinand
In advanced heart failure (HF), chronic inotropic therapy with intravenous milrinone, a phosphodiesterase III inhibitor, is used as a bridge to advanced management that includes transplantation, ventricular assist device implantation, or palliation. This is especially true when repeated attempts to wean off inotropic support result in symptomatic hypotension, worsened symptoms, and/or progressive organ dysfunction. Unfortunately, patients in this clinical predicament are considered hemodynamically labile and may escape the benefits of guideline-directed HF therapy...
July 26, 2016: World Journal of Cardiology
Nicholas O Dillman, Marc M Anders, Brady S Moffett
Hydralazine is a direct peripheral arterial vasodilator used for acute hypertension. Usually administered as a bolus dose, continuous infusion has been described during pregnancy for preeclampsia and eclampsia and in limited reports in cardiac surgeries for afterload reduction. This case describes the use of continuous infusion hydralazine for afterload reduction in an infant receiving extracorporeal membrane oxygenation (ECMO) post-cardiac surgery. Postsurgery, the patient's mean arterial pressures (MAPs) could not be controlled despite escalating doses of vasodilatory medications including nitroprusside, nicardipine, and milrinone; hence, continuous infusion hydralazine was initiated...
May 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Geert Koster, Hanneke J Bekema, Jørn Wetterslev, Christian Gluud, Frederik Keus, Iwan C C van der Horst
INTRODUCTION: Milrinone is an inotrope widely used for treatment of cardiac failure. Because previous meta-analyses had methodological flaws, we decided to conduct a systematic review of the effect of milrinone in critically ill adult patients with cardiac dysfunction. METHODS: This systematic review was performed according to The Cochrane Handbook for Systematic Reviews of Interventions. Searches were conducted until November 2015. Patients with cardiac dysfunction were included...
September 2016: Intensive Care Medicine
Ségolène Mrozek, Mohamed Srairi, Fouad Marhar, Clément Delmas, François Gaussiat, Timothée Abaziou, Claire Larcher, Vincent Atthar, Rémi Menut, Olivier Fourcade, Thomas Geeraerts
BACKGROUND: Takotsubo cardiomyopathy can occur at the early phase of severe acute brain injuries. In the case of cardiac output decrease or shock, the optimal treatment is still a matter of debate. Due to massive stress hormone release, the infusion of catecholamines may have limited effects and may even aggravate cardiac failure. Other inotropic agents may be an option. Levosimendan has been shown to have potential beneficial effects in this setting, although milrinone has not been studied...
September 2016: Heart & Lung: the Journal of Critical Care
Manchula Navaratnam, Ann Ng, Glyn D Williams, Katsuhide Maeda, Julianne M Mendoza, Waldo Concepcion, Seth A Hollander, Chandra Ramamoorthy
BACKGROUND: Combined heart and liver transplantation (CHLT) in the pediatric population involves a complex group of patients, many of whom have palliated congenital heart disease (CHD) involving single ventricle physiology. OBJECTIVE: The purpose of this study was to describe the perioperative management of pediatric patients undergoing CHLT at a single institution and to identify management strategies that may be used to optimize perioperative care. METHODS: We did a retrospective database review of all patients receiving CHLT at a children's hospital between 2006 and 2014...
October 2016: Paediatric Anaesthesia
Anke K Furck, Siân Bentley, Margarita Bartsota, Michael L Rigby, Zdenek Slavik
Phosphodiesterase 3 inhibitors have been used successfully in pediatric patients with acute or chronic myocardial dysfunction over the last two decades. Their protracted continuous intravenous administration is associated with risk of infectious and thromboembolic complications. Weaning intravenous medication and starting oral angiotensin-converting enzyme (ACE) inhibitors and/or beta-blockers can be challenging. We reviewed retrospectively hospital records of 48 patients receiving oral enoximone treatment in a single tertiary pediatric cardiac center between November 2005 and April 2014...
October 2016: Pediatric Cardiology
Brady S Moffett, Timothy J Humlicek, Joseph W Rossano, Jack F Price, Antonio G Cabrera
OBJECTIVE: To assess the frequency of inpatient 30-day readmission for heart failure in children with cardiomyopathy discharged after an admission for heart failure and the impact of discharge pharmacotherapy on readmissions. STUDY DESIGN: The Pediatric Health Information System Database was queried for patients ≤18 years of age with an International Classification of Diseases, Ninth Revision code for heart failure (428.xx) or cardiomyopathy (425.xx) discharged from 2004 to 2013...
October 2016: Journal of Pediatrics
T K Susheel Kumar, Jerry Allen Ccp, Thomas Spentzas Md, Lindsay Berrios Ccp, Samir Shah Md, Vijaya M Joshi Md, Jean A Ballweg Md, Christopher J Knott-Craig Md
OBJECTIVE: Acute kidney injury (AKI) following cardiac surgery is a serious complication with a reported incidence of 30% to 50%. This study sought to determine the prevalence and risk factors for AKI among neonates and young infants undergoing repair of cardiac defects at an institution using novel perioperative strategies. METHODS: A retrospective analysis of 102 consecutive infants (<2 months) undergoing repair of cardiac defects on cardiopulmonary bypass formed the study group...
July 2016: World Journal for Pediatric & Congenital Heart Surgery
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