HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kwak, Y.L. Articles by Hong, Y.W. Search for Related Content PubMed PubMed Citation Articles by Kwak, Y.L. Articles by Hong, Y.W. Related Collections Coronary disease

Eur J Cardiothorac Surg 2004;26:687-693
© 2004 Elsevier Science NL

Efficacy of pre-emptive milrinone in off-pump coronary artery bypass surgery: comparison between patients with a low and normal pre-graft cardiac index

^a Department of Anesthesiology and Pain Medicine and Anesthesia and Pain Research Institute, Yonsei Cardiovascular Research Institute, Yonsei University School of Medicine, 134 Shinchon-Dong, Seodaemun-Gu, Seoul 120-752, South Korea
^b Department of Anesthesiology and Pain Medicine, Inha University School of Medicine, 7-206, 3rd St. Shinheung-Dong, Chung-Gu, Inchon 402-751, South Korea

Received 18 March 2004; received in revised form 22 June 2004; accepted 1 July 2004.

^* Corresponding author. Tel.: +82-02-361-7200; fax: +82-02-361-2951. (E-mail: ywhong{at}yumc.yonsei.ac.kr).

Objective: The effect of pre-emptive milrinone without bolus during off-pump coronary artery bypass surgery (OPCAB) was evaluated in two groups of patients with low and normal pre-graft cardiac index. Methods: Eighty-two patients were divided into two groups based on their pre-graft cardiac index. Each group was randomly subdivided into two groups to receive either milrinone or normal saline. After the internal mammary artery was harvested, the infusion of milrinone, or normal saline was started and maintained until the end of the anastomosis. The haemodynamic variables were measured: just before the start of milrinone or normal saline after pericardiotomy (baseline value); 10min after the tissue stabilizer had been applied for the anastomosis of left anterior descending artery, left circumflex artery and right coronary artery; and after the sternal closure. Results: Milrinone reduced the extent of the decrease in cardiac index and stroke volume as well as the extent of the increase in systemic and pulmonary vascular resistance. The extent of the decrease in cardiac index and mixed venous oxygen saturation were greater in normal pre-graft cardiac index group than in low pre-graft cardiac index group regardless of milrinone infusion during anastomoses. The effect of milrinone on haemodynamics showed no significant difference between low and normal pre-graft cardiac index groups. Conclusions: Pre-emptive milrinone infusion without bolus effectively improved cardiac performance during OPCAB and was especially useful for patients with low pre-graft cardiac index to prevent the decrease in cardiac index and stroke volume index below the critical level.

This article has been cited by other articles:

				A. Y. Denault, Y. Lamarche, P. Couture, F. Haddad, J. Lambert, J.-C. Tardif, and L. P. Perrault Inhaled milrinone: a new alternative in cardiac surgery? Seminars in Cardiothoracic and Vascular Anesthesia, December 1, 2006; 10(4): 346 - 360. [Abstract] [PDF]

				A. Sidi, J. D. Muehlschlegel, D. S. Kirby, and E. B. Lobato Treatment of ischaemic left ventricular dysfunction with milrinone or dobutamine administered during coronary artery stenosis in the presence of beta blockade in pigs Br. J. Anaesth., December 1, 2006; 97(6): 799 - 807. [Abstract] [Full Text] [PDF]