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폐동맥고혈압이 있는 판막 심장병 환자에서 Milrinone은 혈역학적 변수에 어떤 영향을 미치는가?

Other Titles
 Does Milrinone Improve Hemodynamic Variables in Patients with Pulmonary Hypertension Due to Valvular Heart Disease? 
 심연희  ;  오영준  ;  곽영란  ;  홍용우  ;  김에스더  ;  남상범 
 Journal of Korean Society of Anesthesiologist (대한마취과학회지), Vol.44(2) : 187-192, 2003 
Journal Title
Journal of Korean Society of Anesthesiologist(대한마취과학회지)
Issue Date
Inotropes ; milrinone ; pulmonary hypertension ; valvular heart disease ; vasodilation
Inotropes ; milrinone ; pulmonary hypertension ; valvular heart disease ; vasodilation
Background: Milrinone is a bipyridine phosphodiesterase III inhibitor that exerts both positive inotropic and direct vasodilatory effects. The efficacy and safety of intravenous milrinone in heart failure has been evaluated in a number of clinical studies. In addition, performance of the right ventricle is improved primarily in reduced right ventricular afterload, and pulmonary vascular resistence as milrinone produces minimal inotropic effects on the right ventricle. Most clinical studies have been performed in left ventricular failure patients. Therefore, we investigated whether intravenous milrinone improves the hemodynamics in patients with pulmonary hypertension due to valvular heart disease.
Methods: This study included 33 patients undergoing a valvular replacement with pulmonary hypertension (mean pulmonary artery pressure ≥ 30 mmHg after induction). Patients were randomly divided into two groups, normal saline group (N) and milrinone group (M). In group N, normal saline was infused. In group M, a single intravenous bolus of milrinone (50μg/kg body weight) was injected over 10 min. Hemodynamic data were measured at preinjection, 5, 10, and 20 min after injection.

Results: There was no significant difference in systemic mean arterial pressure and central venous pressure between both groups. In group M, systemic vascular resistance was reduced at 5 min after injection and cardiac index was improved at 10 min after injection. There was no significant difference in pulmonary mean arterial pressure and vascular resistance between both groups.

Conclusions: Milrinone had no effect on pulmonary artery pressure and pulmonary vascular resistance in patients with pulmonary hypertension due to valvular heart disease. However, it increased cardiac index and decreased systemic vascular resistance.
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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
Nam, Sang Beom(남상범) ORCID logo https://orcid.org/0000-0002-9704-1866
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
Hong, Yong Woo(홍용우)
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