Does Inhaled Milrinone Facilitate Weaning From Cardiopulmonary Bypass in Children with Congenital Heart Diseases Complicated with Pulmonary Arterial Hypertension?
Yıl: 2020 Cilt: 48 Sayı: 2 Sayfa Aralığı: 127 - 133 Metin Dili: İngilizce DOI: 10.5152/TJAR.2019.91145 İndeks Tarihi: 06-11-2020
Does Inhaled Milrinone Facilitate Weaning From Cardiopulmonary Bypass in Children with Congenital Heart Diseases Complicated with Pulmonary Arterial Hypertension?
Öz: Objective: The aim of the present study was to evaluate the efficacy of inhaled milrinone in controlling pulmonary arterial hypertension (PAH)in paediatric cardiac surgery and its effect on weaning from cardiopulmonary bypass (CPB).Methods: A total of 40 patients with congenital heart diseases complicated by PAH submitted to cardiac surgery requiring CPB were includedin the present study and were randomly classified into the control group (n=20) who received intravenous milrinone 0.5 μg kg-1 min-1 and theinhaled group (n=20) who received inhaled milrinone 50 μg kg-1 before initiation and just before weaning off CPB. Mean pulmonary arterypressure (mPAP), mean systemic arterial pressure (MAP), heart rate (HR), MAP/mPAP ratio, vasoactive drug requirements and time needed towean the patients from CPB were collected.Results: mPAP and HR were significantly lower, and MAP and MAP/mPAP ratio were significantly higher in the inhaled group than in thecontrol group. Vasoactive drug requirements were significantly lesser, and the time needed to wean the patients was significantly shorter in theinhaled group than in the control group.Conclusion: Milrinone inhalation facilitated the weaning from CPB as it significantly reduced mPAP and maintained MAP with subsequentlyless needs for vasoactive drugs.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. van der Linde D, Konings EE, Slager MA, Witsenburg M, Helbing WA, Takkenberg JJ, et al. Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. J Am Coll Cardiol 2011; 58: 2241-7. [CrossRef]
- 2. Chelo D, Nguefack F, Menanga AP, Ngo Um S, Gody JC, Tatah SA, et al. Spectrum of heart diseases in children: an echocardiographic study of 1,666 subjects in a pediatric hospital, Yaounde, Cameroon. Cardiovasc Diagn Ther 2016; 6: 10-9.
- 3. Diller GP, Kempny A, Inuzuka R, Radke R, Wort SJ, Baumgartner H, et al. Survival prospects of treatment naïve patients with Eisenmenger: a systematic review of the literature and report of own experience. Heart 2014; 100: 1366-72. [CrossRef]
- 4. Kameny RJ, Fineman J, Adatia I. Perioperative Management of Paediatric Pulmonary Hypertension. Advances in Pulmonary Hypertension 2016; 15: 87-91. [CrossRef]
- 5. Dimopoulos K, Wort SJ, Gatzoulis MA. Pulmonary hypertension related to congenital heart disease: a call for action. Eur Heart J 2014; 35: 691-700. [CrossRef]
- 6. Kaestner M, Schranz D, Warnecke G, Apitz C, Hansmann G, Miera O. Pulmonary hypertension in the intensive care unit. Expert consensus statement on the diagnosis and treatment of paediatric pulmonary hypertension. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and DGPK. Heart 2016; 102: 57-66. [CrossRef]
- 7. Serrano CV Jr, Souza JA, Lopes NH, Fernandes JL, Nicolau JC, Blotta MH, et al. Reduced expression of systemic proinflammatory and myocardial biomarkers after off-pump versus on-pump coronary artery bypass surgery: a prospective randomized study. J Crit Care 2010; 25: 305-12. [CrossRef]
- 8. Le Hiress M, Tu L, Ricard N, Phan C, Thuillet R, Fadel E, et al. Proinflammatory signature of the dysfunctional endothelium in pulmonary hypertension role of the macrophage migration inhibitory factor/ CD74 complex. Am J Respir Crit Care Med 2015; 192: 983-97. [CrossRef]
- 9. Aljure OD, Fabbro M 2nd. Cardiopulmonary Bypass and Inflammation: The Hidden Enemy. J Cardiothorac Vasc 2019; 33: 346-7. [CrossRef]
- 10. Nielsen DV, Torp-Pedersen C, Skals RK, Gerds TA, Karaliunaite Z, Jakobsen CJ. Intraoperative milrinone versus dobutamine in cardiac surgery patients: A retrospective cohort study on mortality. Crit Care 2018; 22: 51. [CrossRef]
- 11. Mladěnka P, Applová L, Patočka J, Costa VM, Remiao F, Pourová J, et al. Comprehensive review of cardiovascular toxicity of drugs and related agents. Med Res Rev 2018; 38: 1332-403. [CrossRef]
- 12. Haddad F, Couture P, Tousignant C, Denault AY. The right ventricle in cardiac surgery, a perioperative perspective: II. Pathophysiology, clinical importance, and management. Anesth Analg 2009; 108: 422-33. [CrossRef]
- 13. Kundra TS, Prabhakar V, Kaur P, Manjunatha N, Gandham R. The Effect of Inhaled Milrinone Versus Inhaled Levosimendan in Pulmonary Hypertension Patients Undergoing Mitral Valve Surgery - A Pilot Randomized Double-Blind Study. J Cardiothorac Vasc Anesth 2018; 32: 2123-9. [CrossRef]
- 14. Wang H, Gong M, Zhou B, Dai A. Comparison of inhaled and intravenous milrinone in patients with pulmonary hypertension undergoing mitral valve surgery. Adv Ther 2009; 26: 462-8. [CrossRef]
- 15. Denault AY, Haddad F, Lamarche Y, Nguyen AQ, Varin F, Levesque S, et al. Pilot randomized controlled trial of inhaled milrinone in high-risk cardiac surgical patients. Surgery Curr Res 2014; 4: 192.
- 16. Denault AY, Bussières JS, Arellano R, Finegan B, Gavra P, Haddad F, et al. A multicentre randomized-controlled trial of inhaled milrinone in high-risk cardiac surgical patients. Can J Anaesth 2016; 63: 1140-53. [CrossRef]
- 17. Rong LQ, Rahouma M, Abouarab A, Di Franco A, Calautti NM, Fitzgerald MM, et al. Intravenous and inhaled milrinone in adult cardiac surgery patients: A pairwise and network meta-analysis. J Cardiothorac Vasc Anesth 2019; 33: 663-73. [CrossRef]
- 18. Lamarche Y, Perrault LP, Maltais S, Tétreault K, Lambert J, Denault AY. Preliminary experience with inhaled milrinone in cardiac surgery. Eur J Cardiothorac Surg 2007; 31: 1081-7. [CrossRef]
- 19. Robitaille A, Denault AY, Couture P, Belisle S, Fortier A, Guertin MC, et al. Importance of relative pulmonary hypertension in cardiac surgery: the mean systemic to pulmonary artery pressure ratio. J Cardiothor Vasc Anesth 2006; 20: 331-9. [CrossRef]
- 20. Kaw R, Pasupuleti V, Deshpande A, Hamieh T, Walker E, Minai OA. Pulmonary hypertension: An important predictor of outcomes in patients undergoing non-cardiac surgery. Respir Med 2011; 105: 619-24. [CrossRef]
- 21. Lamarche Y, Malo O, Thorin E, Denault A, Carrier M, Roy J, et al. Inhaled but not intravenous milrinone prevents pulmonary endothelial dysfunction after cardiopulmonary bypass. J Thorac Cardiovasc Surg 2005; 130:83-92. [CrossRef]
- 22. Laflamme M, Perrault LP, Carrier M, Elmi-Sarabi M, Fortier A, Denault AY. Preliminary experience with combined inhaled milrinone and prostacyclin in cardiac surgical patients with pulmonary hypertension. J Cardiothorac Vasc Anesth 2015; 29: 38-45. [CrossRef]
- 23. St-Pierre P, Deschamps A, Cartier R, Basmadjian A, Denault AY. Inhaled milrinone and epoprostenol in a patient with severe pulmonary hypertension, right ventricular failure and reduced baseline brain saturation value from a left atrial myxoma. J Cardiothorac Vasc Anesth 2014; 28: 723-9. [CrossRef]
| APA | ELBASER I, EL DERIE A (2020). Does Inhaled Milrinone Facilitate Weaning From Cardiopulmonary Bypass in Children with Congenital Heart Diseases Complicated with Pulmonary Arterial Hypertension?. , 127 - 133. 10.5152/TJAR.2019.91145 |
| Chicago | ELBASER Ibrahim Ibrahim Abd,EL DERIE Ahmad Abd El Aleem Does Inhaled Milrinone Facilitate Weaning From Cardiopulmonary Bypass in Children with Congenital Heart Diseases Complicated with Pulmonary Arterial Hypertension?. (2020): 127 - 133. 10.5152/TJAR.2019.91145 |
| MLA | ELBASER Ibrahim Ibrahim Abd,EL DERIE Ahmad Abd El Aleem Does Inhaled Milrinone Facilitate Weaning From Cardiopulmonary Bypass in Children with Congenital Heart Diseases Complicated with Pulmonary Arterial Hypertension?. , 2020, ss.127 - 133. 10.5152/TJAR.2019.91145 |
| AMA | ELBASER I,EL DERIE A Does Inhaled Milrinone Facilitate Weaning From Cardiopulmonary Bypass in Children with Congenital Heart Diseases Complicated with Pulmonary Arterial Hypertension?. . 2020; 127 - 133. 10.5152/TJAR.2019.91145 |
| Vancouver | ELBASER I,EL DERIE A Does Inhaled Milrinone Facilitate Weaning From Cardiopulmonary Bypass in Children with Congenital Heart Diseases Complicated with Pulmonary Arterial Hypertension?. . 2020; 127 - 133. 10.5152/TJAR.2019.91145 |
| IEEE | ELBASER I,EL DERIE A "Does Inhaled Milrinone Facilitate Weaning From Cardiopulmonary Bypass in Children with Congenital Heart Diseases Complicated with Pulmonary Arterial Hypertension?." , ss.127 - 133, 2020. 10.5152/TJAR.2019.91145 |
| ISNAD | ELBASER, Ibrahim Ibrahim Abd - EL DERIE, Ahmad Abd El Aleem. "Does Inhaled Milrinone Facilitate Weaning From Cardiopulmonary Bypass in Children with Congenital Heart Diseases Complicated with Pulmonary Arterial Hypertension?". (2020), 127-133. https://doi.org/10.5152/TJAR.2019.91145 |
| APA | ELBASER I, EL DERIE A (2020). Does Inhaled Milrinone Facilitate Weaning From Cardiopulmonary Bypass in Children with Congenital Heart Diseases Complicated with Pulmonary Arterial Hypertension?. Turkish Journal of Anaesthesiology and Reanimation, 48(2), 127 - 133. 10.5152/TJAR.2019.91145 |
| Chicago | ELBASER Ibrahim Ibrahim Abd,EL DERIE Ahmad Abd El Aleem Does Inhaled Milrinone Facilitate Weaning From Cardiopulmonary Bypass in Children with Congenital Heart Diseases Complicated with Pulmonary Arterial Hypertension?. Turkish Journal of Anaesthesiology and Reanimation 48, no.2 (2020): 127 - 133. 10.5152/TJAR.2019.91145 |
| MLA | ELBASER Ibrahim Ibrahim Abd,EL DERIE Ahmad Abd El Aleem Does Inhaled Milrinone Facilitate Weaning From Cardiopulmonary Bypass in Children with Congenital Heart Diseases Complicated with Pulmonary Arterial Hypertension?. Turkish Journal of Anaesthesiology and Reanimation, vol.48, no.2, 2020, ss.127 - 133. 10.5152/TJAR.2019.91145 |
| AMA | ELBASER I,EL DERIE A Does Inhaled Milrinone Facilitate Weaning From Cardiopulmonary Bypass in Children with Congenital Heart Diseases Complicated with Pulmonary Arterial Hypertension?. Turkish Journal of Anaesthesiology and Reanimation. 2020; 48(2): 127 - 133. 10.5152/TJAR.2019.91145 |
| Vancouver | ELBASER I,EL DERIE A Does Inhaled Milrinone Facilitate Weaning From Cardiopulmonary Bypass in Children with Congenital Heart Diseases Complicated with Pulmonary Arterial Hypertension?. Turkish Journal of Anaesthesiology and Reanimation. 2020; 48(2): 127 - 133. 10.5152/TJAR.2019.91145 |
| IEEE | ELBASER I,EL DERIE A "Does Inhaled Milrinone Facilitate Weaning From Cardiopulmonary Bypass in Children with Congenital Heart Diseases Complicated with Pulmonary Arterial Hypertension?." Turkish Journal of Anaesthesiology and Reanimation, 48, ss.127 - 133, 2020. 10.5152/TJAR.2019.91145 |
| ISNAD | ELBASER, Ibrahim Ibrahim Abd - EL DERIE, Ahmad Abd El Aleem. "Does Inhaled Milrinone Facilitate Weaning From Cardiopulmonary Bypass in Children with Congenital Heart Diseases Complicated with Pulmonary Arterial Hypertension?". Turkish Journal of Anaesthesiology and Reanimation 48/2 (2020), 127-133. https://doi.org/10.5152/TJAR.2019.91145 |
