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The Effect of Milrinone on the Right Ventriclular Function in Patients with Reduced Right Ventricular Function Undergoing Off-pump Coronary Artery Bypass Graft Surgery

Authors
 Jong Hwa Lee  ;  Young Jun Oh  ;  Yon Hee Shim  ;  Yong Woo Hong  ;  Gijong Yi  ;  Young Lan Kwak 
Citation
 JOURNAL OF KOREAN MEDICAL SCIENCE, Vol.21(5) : 854-858, 2006 
Journal Title
 JOURNAL OF KOREAN MEDICAL SCIENCE 
ISSN
 1011-8934 
Issue Date
2006
MeSH
Aged ; Blood Pressure/drug effects ; Coronary Artery Bypass, Off-Pump* ; Echocardiography, Transesophageal ; Female ; Heart Rate/drug effects ; Humans ; Male ; Middle Aged ; Milrinone/pharmacology* ; Phosphodiesterase Inhibitors/pharmacology* ; Ventricular Function, Right/drug effects*
Keywords
Milrinone ; Ventricular Function ; Right ; Thermodilution ; Coronary Artery Bypass ; Off-pump
Abstract
This investigation evaluated the effect of continuous milrinone infusion on right ventriclular (RV) function during off-pump coronary artery bypass graft (OPCAB) surgery in patients with reduced RV function. Fifty patients scheduled for OPCAB, with thermodilution RV ejection fraction (RVEF) <35% after anesthesia induction, were randomly allocated to either milrinone (0.5 µg/kg/min) or control (saline) group. Hemodynamic variables and RV volumetric data measured by thermodilution method were collected as follows: after anesthesia induction (T1); 10 min after heart displacement for obtuse marginal artery anastomosis (T2); after pericardial closure (T3). Cardiac index and heart rate increased and systemic vascular resistance significantly decreased in milrinone group at T2. Initially lower RVEF of milrinone group was eventually comparable to control group after milrinone infusion. RVEF did not significantly change at T2 and T3 in both groups. RV end-diastolic volume in milrinone group consistently decreased from the baseline at T2 and T3. Continuous infusion of milrinone without a bolus demonstrated potentially beneficial effect on cardiac output and RV afterload in patients with reduced RV function during OPCAB. However, aggressive augmentation of intravascular volume seems to be necessary to maximize the effect of the milrinone in these patients.
Files in This Item:
T200604142.pdf Download
DOI
10.3346/jkms.2006.21.5.854
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Shim, Yon Hee(심연희) ORCID logo https://orcid.org/0000-0003-1921-3391
Oh, Young Jun(오영준) ORCID logo https://orcid.org/0000-0002-6258-5695
Yi, Gi Jong(이기종)
Lee, Jong Wha(이종화)
Hong, Yong Woo(홍용우)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/110961
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