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https://www.readbyqxmd.com/read/28208977/comparison-of-levosimendan-milrinone-and-dobutamine-in-treating-low-cardiac-output-syndrome-following-valve-replacement-surgeries-with-cardiopulmonary-bypass
#1
Sunny, Mohd Yunus, Habib Md Reazaul Karim, Manuj Kumar Saikia, Prithwis Bhattacharyya, Samarjit Dey
INTRODUCTION: Low Cardiac Output Syndrome (LCOS) following Cardiopulmonary Bypass (CPB) is common and associated with increased mortality. Maintenance of adequate cardiac output is one of the primary objectives in management of such patients. AIM: To compare Levosimendan, Milrinone and Dobutamine for the treatment of LCOS after CPB in patients who underwent valve replacement surgeries. MATERIALS AND METHODS: Sixty eligible patients meeting LCOS were allocated into three treatment groups: Group A-Levosimendan (loading dose 10μg/kg over 10 minutes, followed by 0...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208674/synthesis-and-positive-inotropic-activity-of-1-2-4-triazolo-4-3-a-quinoxaline-derivatives-bearing-substituted-benzylpiperazine-and-benzoylpiperazine-moieties
#2
Xue-Kun Liu, Long-Xu Ma, Zhi-Yu Wei, Xun Cui, Shi Zhan, Xiu-Mei Yin, Hu-Ri Piao
In an attempt to search for more potent positive inotropic agents, two series of [1,2,4]triazolo[4,3-a] quinoxaline derivatives bearing substituted benzylpiperazine and benzoylpiperazine moieties were synthesized and their positive inotropic activities evaluated by measuring left atrial stroke volume in isolated rabbit heart preparations. Several compounds showed favorable activities compared with the standard drug, milrinone. Compound 6c was the most potent agent, with an increased stroke volume of 12.53% ± 0...
February 11, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28184975/alkaline-phosphatase-a-biomarker-of-cardiac-function-in-pediatric-patients
#3
Elizabeth S Makil, Xinyu Tang, Elizabeth A Frazier, R Thomas Collins
Myocardial dysfunction and heart failure are common in pediatric patients with congenital and acquired heart disease. Alkaline phosphatase (AP) has been suggested as a biomarker for myocardial dysfunction after Fontan operation. We hypothesized that pediatric patients with myocardial dysfunction requiring orthotopic heart transplant (OHT) have diminished AP compared to normal. A retrospective review was performed in all patients who underwent OHT at Arkansas Children's Hospital between January 2007 and October 2012...
February 9, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28144392/vasopressin-use-in-critically-ill-cirrhosis-patients-with-catecholamine-resistant-septic-shock-the-cvicu-cohort
#4
Lukasz A Myc, Jonathan G Stine, Rinita Chakrapani, Alexandra Kadl, Curtis K Argo
AIM: To examine patient-centered outcomes with vasopressin (AVP) use in patients with cirrhosis with catecholamine-refractory septic shock. METHODS: We conducted a single center, retrospective cohort study enrolling adult patients with cirrhosis treated for catecholamine-resistant septic shock in the intensive care unit (ICU) from March 2011 through December 2013. Other etiologies of shock were excluded. Multivariable regression models were constructed for seven and 28-d mortality comparing AVP as a second-line therapy to a group of all other vasoactive agents...
January 18, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28141793/sex-specific-associations-between-cerebrovascular-blood-pressure-autoregulation-and-cardiopulmonary-injury-in-neonatal-encephalopathy-and-therapeutic-hypothermia
#5
Raul Chavez-Valdez, Matthew O'Connor, Jamie Perin, Michael Reyes, Jillian Armstrong, Charlamaine Parkinson, Maureen Gilmore, Jacky Jennings, Frances J Northington, Jennifer K Lee
BACKGROUND: Cardiopulmonary injury is common in neonatal encephalopathy, but the link with cerebrovascular dysfunction is unknown. We hypothesized that cerebral autoregulation is associated with cardiopulmonary injury in neonates treated with therapeutic hypothermia (TH) for neonatal encephalopathy. METHODS: The cerebral hemoglobin volume index (HVx) from near-infrared spectroscopy was used to identify the mean arterial blood pressure (MAP) with optimal autoregulatory vasoreactivity (MAPOPT)...
January 31, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28137353/management-of-neonatal-hypotension
#6
Brian T Kalish
Hypotension is a common problem in neonates with complex underlying pathophysiology. Although treatment of low blood pressure is common, clinicians must use all available information to target neonates with compromised perfusion. Pharmacotherapy should be tailored to the specific physiologic perturbations of the individual neonate. Dopamine is the most commonly utilized agent and may be the most appropriate agent for septic shock with low diastolic blood pressure. However, alternative therapies should be considered for other etiologies of hypotension, including milrinone and vasopressin for persistent pulmonary hypertension of the newborn and dobutamine for patent ductus arteriosus...
January 1, 2017: Neonatal Network: NN
https://www.readbyqxmd.com/read/28133984/new-arylsparteine-derivatives-as-positive-inotropic-drugs
#7
Vito Boido, Marcella Ercoli, Michele Tonelli, Federica Novelli, Bruno Tasso, Fabio Sparatore, Elena Cichero, Paola Fossa, Paola Dorigo, Guglielmina Froldi
Positive inotropic agents are fundamental in the treatment of heart failure; however, their arrhythmogenic liability and the increased myocardial oxygen demand strongly limit their therapeutic utility. Pursuing our study on cardiovascular activities of lupin alkaloid derivatives, several 2-(4-substituted-phenyl)-2-dehydrosparteines and 2-(4-substituted-phenyl)sparteines were prepared and tested for inotropic and chronotropic activities on isolated guinea pig atria. Four compounds (6b, 6e, 7b, and 7f) exhibited significant inotropism that, at the higher concentrations, was followed by negative inotropism or toxicity...
December 2017: Journal of Enzyme Inhibition and Medicinal Chemistry
https://www.readbyqxmd.com/read/28131674/milrinone-therapeutic-drug-monitoring-in-a-pediatric-population-development-and-validation-of-a-quantitative-liquid-chromatography-tandem-mass-spectrometry-method
#8
Joshua E Raizman, Katherine Taylor, Christopher Parshuram, David A Colantonio
BACKGROUND: Milrinone is a potent selective phosphodiesterase type III inhibitor which stimulates myocardial function and improves myocardial relaxation. Although therapeutic monitoring is crucial to maintain therapeutic outcome, little data is available. A proof-of-principle study has been initiated in our institution to evaluate the clinical impact of optimizing milrinone dosing through therapeutic drug monitoring (TDM) in children following cardiac surgery. We developed a robust LC-MS/MS method to quantify milrinone in serum from pediatric patients in real-time...
January 25, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28099979/milrinone-pharmacokinetics-and-pharmacodynamics-in-neonates-with-persistent-pulmonary-hypertension-of-the-newborn
#9
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
#10
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
#11
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
#12
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
#13
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...
March 2017: 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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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