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[PMID]:28632543
[Au] Autor:Lee J; Kim WH; Ryu HG; Lee HC; Chung EJ; Yang SM; Jung CW
[Ad] Endereço:From the *Department of Anesthesiology and Pain Medicine, Keimyung University Dongsan Medical Center, Keimyung University College of Medicine; and †Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
[Ti] Título:Stroke Volume Variation-Guided Versus Central Venous Pressure-Guided Low Central Venous Pressure With Milrinone During Living Donor Hepatectomy: A Randomized Double-Blinded Clinical Trial.
[So] Source:Anesth Analg;125(2):423-430, 2017 Aug.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We previously demonstrated the usefulness of milrinone for living donor hepatectomy. However, a less-invasive alternative to central venous catheterization and perioperative contributors to good surgical outcomes remain undetermined. The current study evaluated whether the stroke volume variation (SVV)-guided method can substitute central venous catheterization during milrinone-induced profound vasodilation. METHODS: We randomly assigned 42 living liver donors to receive either SVV guidance or central venous pressure (CVP) guidance to obtain milrinone-induced low CVP. Target SVV of 9% was used as a substitute for CVP of 5 mm Hg. The surgical field grade evaluated by 2 attending surgeons on a 4-point scale was compared between the CVP- and SVV-guided groups (n = 19, total number of scores = 38 per group) as a primary outcome variable. Multivariable analysis was performed to identify independent factors associated with the best surgical field as a post hoc analysis. RESULTS: Surgical field grades, which were either 1 or 2, were not found to be different between the 2 groups via Mann-Whitney U test (P = .358). There was a very weak correlation between SVV and CVP during profound vasodilation such as CVP ≤ 5 mm Hg (R = -0.06; 95% confidence interval, -0.09 to -0.04; P < .001). Additional post hoc analysis suggested that younger age, lower baseline CVP, and longer duration of milrinone infusion might be helpful in providing the best surgical field. CONCLUSIONS: Milrinone-induced vasodilation resulted in favorable surgical environment regardless of guidance methods of low CVP during living donor hepatectomy. However, SVV was not a useful indicator of low CVP because of very weak correlation between SVV and CVP during profound vasodilation. In addition, factors contributing to the best surgical field such as donor age, proactive fasting, and proper dosing of milrinone need to be investigated further, ideally through prospective studies.
[Mh] Termos MeSH primário: Pressão Venosa Central/efeitos dos fármacos
Hepatectomia
Doadores Vivos
Milrinona/administração & dosagem
Volume Sistólico/efeitos dos fármacos
[Mh] Termos MeSH secundário: Adulto
Cateterismo
Cateterismo Venoso Central
Método Duplo-Cego
Feminino
Seres Humanos
Modelos Lineares
Fígado/efeitos dos fármacos
Masculino
Meia-Idade
Monitorização Intraoperatória/métodos
Análise Multivariada
Inibidores da Agregação de Plaquetas/administração & dosagem
Estudos Prospectivos
Tamanho da Amostra
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Platelet Aggregation Inhibitors); JU9YAX04C7 (Milrinone)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170621
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002197


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[PMID]:28248808
[Au] Autor:Curley M; Liebers J; Maynard R
[Ad] Endereço:Pediatric Home Service (Ms Curley and Dr Liebers), and Children's Hospitals and Clinics of Minnesota (Dr Maynard). Michelle Curley, RN, CRNI®, is an infusion nurse manager at Pediatric Home Service, Roseville, MN. Jill Liebers, PharmD, is a pharmacy manager at Pediatric Home Service, Roseville, MN. Roy Maynard, MD, is a practicing pediatric pulmonologist on staff at Children's Hospitals and Clinics of Minnesota, Minneapolis, MN. He is also the medical director at Pediatric Home Service, Roseville, MN.
[Ti] Título:Continuous Intravenous Milrinone Therapy in Pediatric Outpatients.
[So] Source:J Infus Nurs;40(2):92-96, 2017 Mar/Apr.
[Is] ISSN:1539-0667
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Milrinone is a phosphodiesterase 3 inhibitor with both positive inotropic and vasodilator properties. Administered as a continuous infusion, milrinone is indicated for the short-term treatment of patients with acute decompensated heart failure. Despite limited data supporting long-term milrinone therapy in adults with congestive heart failure, children managed as outpatients may benefit from continuous milrinone as a treatment for cardiac dysfunction, as a destination therapy for cardiac transplant, or as palliative therapy for cardiomyopathy. The aim of this article is to review the medical literature and describe a home infusion company's experience with pediatric outpatient milrinone therapy.
[Mh] Termos MeSH primário: Cardiotônicos/uso terapêutico
Terapia por Infusões no Domicílio/métodos
Infusões Intravenosas
Milrinona/uso terapêutico
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Esquema de Medicação
Feminino
Insuficiência Cardíaca/tratamento farmacológico
Transplante de Coração
Hemodinâmica/efeitos dos fármacos
Terapia por Infusões no Domicílio/enfermagem
Assistência Domiciliar
Seres Humanos
Lactente
Masculino
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cardiotonic Agents); JU9YAX04C7 (Milrinone)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170717
[Lr] Data última revisão:
170717
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170302
[St] Status:MEDLINE
[do] DOI:10.1097/NAN.0000000000000214


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[PMID]:28208674
[Au] Autor:Liu XK; Ma LX; Wei ZY; Cui X; Zhan S; Yin XM; Piao HR
[Ad] Endereço:Tonghua Normal University , College of Pharmaceutical and Food Science, Tonghua 134002, China. liuxuekunth@126.com.
[Ti] Título:Synthesis and Positive Inotropic Activity of [1,2,4]Triazolo[4,3-a] Quinoxaline Derivatives Bearing Substituted Benzylpiperazine and Benzoylpiperazine Moieties.
[So] Source:Molecules;22(2), 2017 Feb 11.
[Is] ISSN:1420-3049
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:In an attempt to search for more potent positive inotropic agents, two series of [1,2,4]triazolo[4,3- ] 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 was the most potent agent, with an increased stroke volume of 12.53% ± 0.30% (milrinone: 2.46% ± 0.07%) at 3 × 10 M. The chronotropic effects of compounds having considerable inotropic effects were also evaluated.
[Mh] Termos MeSH primário: Cardiotônicos/síntese química
Cardiotônicos/farmacologia
Piperazinas/química
Quinoxalinas/síntese química
Quinoxalinas/farmacologia
[Mh] Termos MeSH secundário: Animais
Relação Dose-Resposta a Droga
Átrios do Coração/efeitos dos fármacos
Insuficiência Cardíaca/tratamento farmacológico
Insuficiência Cardíaca/etiologia
Insuficiência Cardíaca/fisiopatologia
Milrinona/farmacologia
Estrutura Molecular
Contração Miocárdica/efeitos dos fármacos
Coelhos
Volume Sistólico/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cardiotonic Agents); 0 (Piperazines); 0 (Quinoxalines); JU9YAX04C7 (Milrinone)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170509
[Lr] Data última revisão:
170509
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170218
[St] Status:MEDLINE


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[PMID]:28137353
[Au] Autor:Kalish BT
[Ti] Título:Management of Neonatal Hypotension.
[So] Source:Neonatal Netw;36(1):40-47, 2017 Jan 01.
[Is] ISSN:1539-2880
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo: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. Additional studies are required to refine the approach to neonatal hypotension and document the long-term outcomes of treated neonates.
[Mh] Termos MeSH primário: Pressão Sanguínea
Dobutamina/uso terapêutico
Dopamina/uso terapêutico
Hipotensão
Milrinona/uso terapêutico
[Mh] Termos MeSH secundário: Pressão Sanguínea/efeitos dos fármacos
Pressão Sanguínea/fisiologia
Cardiotônicos/uso terapêutico
Permeabilidade do Canal Arterial/complicações
Seres Humanos
Hipotensão/diagnóstico
Hipotensão/etiologia
Hipotensão/fisiopatologia
Hipotensão/terapia
Recém-Nascido
Efeitos Adversos de Longa Duração
Choque Séptico/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cardiotonic Agents); 3S12J47372 (Dobutamine); JU9YAX04C7 (Milrinone); VTD58H1Z2X (Dopamine)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170717
[Lr] Data última revisão:
170717
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170201
[St] Status:MEDLINE
[do] DOI:10.1891/0730-0832.36.1.40


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[PMID]:28069456
[Au] Autor:Mutoh T; Mutoh T; Sasaki K; Nakamura K; Tatewaki Y; Ishikawa T; Taki Y
[Ad] Endereço:Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer (IDAC), Tohoku University, Sendai, Japan; Graduate School of Psychology, Kobe Shoin Women's University, Kobe, Japan.
[Ti] Título:Neurocardiac protection with milrinone for restoring acute cerebral hypoperfusion and delayed ischemic injury after experimental subarachnoid hemorrhage.
[So] Source:Neurosci Lett;640:70-75, 2017 Feb 15.
[Is] ISSN:1872-7972
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo: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 1.5-h after SAH induction. CBF, neurobehavioral function, occurrence of DCI were assessed by MR-continuous arterial spin labeling, daily neurological score testing, and diffusion- and T2-weighted MR images on days 1 and 3, respectively. RESULTS: Initial global CBF depression was notable in mice of control and MIL groups as compared to the SAH-sham group (P<0.05). MIL raised CBF in a dose-dependent manner (P<0.001), resulted in lower incidence of DCI (P=0.008) and better recovery from neurobehavioral decline than control (P<0.001). The CBF values on day 1 predicted DCI with a cut-off of 42.5ml/100g/min (82% specificity and 83% sensitivity), which was greater in mice treated with MIL than those of control (51.7 versus 37.6ml/100g/min; P<0.001). CONCLUSION: MIL improves post-SAH acute hypoperfusion that can lead to the prevention of DCI and functional worsening, acting as a neurocardiac protective agent against EBI.
[Mh] Termos MeSH primário: Isquemia Encefálica/prevenção & controle
Cardiotônicos/uso terapêutico
Córtex Cerebral/efeitos dos fármacos
Milrinona/uso terapêutico
Fármacos Neuroprotetores/uso terapêutico
Traumatismo por Reperfusão/prevenção & controle
Hemorragia Subaracnóidea/tratamento farmacológico
[Mh] Termos MeSH secundário: Animais
Isquemia Encefálica/etiologia
Isquemia Encefálica/fisiopatologia
Córtex Cerebral/irrigação sanguínea
Ecocardiografia Doppler
Coração/diagnóstico por imagem
Coração/fisiopatologia
Masculino
Camundongos Endogâmicos C57BL
Traumatismo por Reperfusão/etiologia
Traumatismo por Reperfusão/fisiopatologia
Hemorragia Subaracnóidea/complicações
Hemorragia Subaracnóidea/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cardiotonic Agents); 0 (Neuroprotective Agents); JU9YAX04C7 (Milrinone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170111
[St] Status:MEDLINE


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[PMID]:28008646
[Au] Autor:Mutoh T; Mutoh T; Nakamura K; Yamamoto Y; Tsuru Y; Tsubone H; Ishikawa T; Taki Y
[Ad] Endereço:Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.
[Ti] Título:Acute cardiac support with intravenous milrinone promotes recovery from early brain injury in a murine model of severe subarachnoid haemorrhage.
[So] Source:Clin Exp Pharmacol Physiol;44(4):463-469, 2017 Apr.
[Is] ISSN:1440-1681
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:Early brain injury/ischaemia (EBI) is a serious complication early after subarachnoid haemorrhage (SAH) that contributes to development of delayed cerebral ischaemia (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. Cardiac output (CO) during intravenous MIL infusion (0.25-0.75 µg/kg/min) between 1.5 and 2.5 hours after SAH induction was monitored with Doppler echocardiography. Magnetic resonance imaging (MRI)-continuous arterial spin labelling was used for quantitative cerebral blood flow (CBF) measurements. Neurobehavioral function was assessed daily by neurological score and open field test. DCI was analyzed 3 days later by determining infarction on MRI. Mild reduction of cardiac output (CO) and global cerebral blood flow (CBF) depression were notable early after SAH. MIL increased CO in a dose-dependent manner (P<.001), which was accompanied by improved hypoperfusion, incidence of DCI and functional recovery than Control (P<.05). The neuroprotective effects afforded by MIL or Control were attenuated by hypoxia-inducible factor (HIF) inhibition (P<.05). These results suggest that MIL improves acute hypoperfusion by its inotropic effect, leading to neurobehavioral improvement in mice after severe SAH, in which HIF may be acting as a critical mediator.
[Mh] Termos MeSH primário: Lesões Encefálicas/complicações
Milrinona/administração & dosagem
Milrinona/farmacologia
Recuperação de Função Fisiológica/efeitos dos fármacos
Hemorragia Subaracnóidea/tratamento farmacológico
Hemorragia Subaracnóidea/fisiopatologia
[Mh] Termos MeSH secundário: Administração Intravenosa
Animais
Isquemia Encefálica/complicações
Circulação Cerebrovascular/efeitos dos fármacos
Modelos Animais de Doenças
Hemodinâmica/efeitos dos fármacos
Masculino
Camundongos
Camundongos Endogâmicos C57BL
Milrinona/uso terapêutico
Hemorragia Subaracnóidea/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
JU9YAX04C7 (Milrinone)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161224
[St] Status:MEDLINE
[do] DOI:10.1111/1440-1681.12718


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[PMID]:27842615
[Au] Autor:Lannes M; Zeiler F; Guichon C; Teitelbaum J
[Ad] Endereço:1McGill University,Department of Anesthesiology,Montreal Neurological Hospital,Montreal,Canada.
[Ti] Título:The Use of Milrinone in Patients with Delayed Cerebral Ischemia Following Subarachnoid Hemorrhage: A Systematic Review.
[So] Source:Can J Neurol Sci;44(2):152-160, 2017 Mar.
[Is] ISSN:0317-1671
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo: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. Quality of the evidence for these outcomes across studies was adjudicated using the GRADE Working Group criteria. RESULTS: The search resulted in 284 citations after elimination of duplicates. Of those 9 conference proceedings and 15 studies met inclusion criteria and consisted of case reports, case series and two comparative studies: one non-randomized study with physiological outcomes only and a case series with historical controls. There was considerable variation in dosing and in co-interventions and no case control or randomized controlled studies were found. CONCLUSION: There is currently only very low quality evidence to support the use of milrinone to improve important outcomes in patients with delayed cerebral ischemia secondary to subarachnoid hemorrhage. Further research is needed to clarify the value and risks of this medication in patients with SAH.
[Mh] Termos MeSH primário: Isquemia Encefálica/tratamento farmacológico
Milrinona/uso terapêutico
Hemorragia Subaracnóidea/complicações
Vasodilatadores/uso terapêutico
[Mh] Termos MeSH secundário: Isquemia Encefálica/etiologia
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Vasodilator Agents); JU9YAX04C7 (Milrinone)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170310
[Lr] Data última revisão:
170310
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161116
[St] Status:MEDLINE
[do] DOI:10.1017/cjn.2016.316


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[PMID]:27756610
[Au] Autor:Ishizaka T; Yoshimatsu Y; Maeda Y; Takasaki W; Chiba K; Mori K
[Ad] Endereço:Medicinal Safety Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo 134-8630, Japan. Electronic address: ishizaka.tomomichi.du@daiichisankyo.co.jp.
[Ti] Título:Promising approach for the preclinical assessment of cardiac risks using left ventricular pressure-volume loop analyses in anesthetized monkeys.
[So] Source:J Pharmacol Toxicol Methods;84:1-10, 2017 Mar - Apr.
[Is] ISSN:1873-488X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo: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 ß-blocker), or dl-sotalol (a ß+I blocker) intravenously over 10min at two dose levels including clinically relevant doses (n=5/drug). RESULTS: Milrinone and metoprolol produced positive and negative inotropy, respectively. These effects were detected as changes in the slope of the preload-recruitable stroke work, which is a load-independent inotropic parameter. However, dl-sotalol did not alter the slope of the preload-recruitable stroke work. That means dl-sotalol produced no inotropy, although it decreased load-dependent inotropic parameters, including maximal upstroke velocity of left ventricular pressure, attributable to decreased heart rate and blood pressure. Other typical pharmacological effects of the compounds tested were also detected. Both ß-blockers produced PR prolongation, decreased left ventricular end-systolic pressure, increased left ventricular end-diastolic pressure, and increased maximal descending velocity of left ventricular pressure and time constant for isovolumic relaxation. dl-Sotalol also prolonged heart-rate-corrected QT interval. Milrinone induced reflex tachycardia, PR shortening, and decreased left ventricular end-diastolic pressure. DISCUSSION: The overall assessment by not only load-dependent inotropic parameters but also load-independent parameters obtained from the ventricular pressure-volume loop analysis using monkeys can provide further appropriate information for the assessment of drug-induced cardiac risks.
[Mh] Termos MeSH primário: Antagonistas Adrenérgicos beta/efeitos adversos
Anestesia
Cardiopatias/induzido quimicamente
Inibidores da Fosfodiesterase 3/efeitos adversos
Pressão Ventricular/efeitos dos fármacos
[Mh] Termos MeSH secundário: Antagonistas Adrenérgicos beta/farmacologia
Anestesia/métodos
Animais
Débito Cardíaco/efeitos dos fármacos
Débito Cardíaco/fisiologia
Cardiotônicos/efeitos adversos
Cardiotônicos/farmacologia
Avaliação Pré-Clínica de Medicamentos/métodos
Feminino
Cardiopatias/fisiopatologia
Frequência Cardíaca/efeitos dos fármacos
Frequência Cardíaca/fisiologia
Hemodinâmica/efeitos dos fármacos
Hemodinâmica/fisiologia
Macaca fascicularis
Masculino
Metoprolol/efeitos adversos
Metoprolol/farmacologia
Milrinona/efeitos adversos
Milrinona/farmacologia
Contração Miocárdica/efeitos dos fármacos
Contração Miocárdica/fisiologia
Inibidores da Fosfodiesterase 3/farmacologia
Fatores de Risco
Sotalol/efeitos adversos
Sotalol/farmacologia
Pressão Ventricular/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adrenergic beta-Antagonists); 0 (Cardiotonic Agents); 0 (Phosphodiesterase 3 Inhibitors); A6D97U294I (Sotalol); GEB06NHM23 (Metoprolol); JU9YAX04C7 (Milrinone)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170707
[Lr] Data última revisão:
170707
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161107
[St] Status:MEDLINE


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[PMID]:27252226
[Au] Autor:Schisler T; Marquez JM; Hilmi I; Subramaniam K
[Ad] Endereço:1 University of Pittsburgh Medical Center Health System, Pittsburgh, PA, USA.
[Ti] Título:Pulmonary Hypertensive Crisis on Induction of Anesthesia.
[So] Source:Semin Cardiothorac Vasc Anesth;21(1):105-113, 2017 Mar.
[Is] ISSN:1940-5596
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Anesthesia for lung transplantation remains one of the highest risk surgeries in the domain of the cardiothoracic anesthesiologist. End-stage lung disease, pulmonary hypertension, and right heart dysfunction as well as other comorbid disease factors predispose the patient to cardiovascular, respiratory and metabolic dysfunction during general anesthesia. Perhaps the highest risk phase of surgery in the patient with severe pulmonary hypertension is during the induction of anesthesia when the removal of intrinsic sympathetic tone and onset of positive pressure ventilation can decompensate a severely compromised cardiovascular system. Severe hypotension, cardiac arrest, and death have been reported previously. Here we present 2 high-risk patients for lung transplantation, their anesthetic induction course, and outcomes. We offer suggestions for the safe management of anesthetic induction to mitigate against hemodynamic and respiratory complications.
[Mh] Termos MeSH primário: Anestesia
Hipertensão Pulmonar/complicações
Hipertensão Pulmonar/terapia
Transplante de Pulmão
[Mh] Termos MeSH secundário: Agonistas alfa-Adrenérgicos/uso terapêutico
Broncodilatadores/uso terapêutico
Cloreto de Cálcio/uso terapêutico
Reanimação Cardiopulmonar/métodos
Cardiotônicos/uso terapêutico
Epinefrina/uso terapêutico
Evolução Fatal
Feminino
Parada Cardíaca/complicações
Parada Cardíaca/fisiopatologia
Parada Cardíaca/terapia
Seres Humanos
Hipertensão Pulmonar/fisiopatologia
Masculino
Meia-Idade
Milrinona/uso terapêutico
Óxido Nítrico/uso terapêutico
Norepinefrina/uso terapêutico
Bicarbonato de Sódio/uso terapêutico
Vasoconstritores/uso terapêutico
Vasopressinas/uso terapêutico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adrenergic alpha-Agonists); 0 (Bronchodilator Agents); 0 (Cardiotonic Agents); 0 (Vasoconstrictor Agents); 11000-17-2 (Vasopressins); 31C4KY9ESH (Nitric Oxide); 8MDF5V39QO (Sodium Bicarbonate); JU9YAX04C7 (Milrinone); M4I0D6VV5M (Calcium Chloride); X4W3ENH1CV (Norepinephrine); YKH834O4BH (Epinephrine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160603
[St] Status:MEDLINE
[do] DOI:10.1177/1089253216652222


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[PMID]:27072674
[Au] Autor:Halliday M; Kavarana M; Ebeling M; Kiger J
[Ad] Endereço:a Department of Pediatrics and.
[Ti] Título:Milrinone use for hemodynamic instability in patent ductus arteriosus ligation.
[So] Source:J Matern Fetal Neonatal Med;30(5):529-533, 2017 Mar.
[Is] ISSN:1476-4954
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Determine if prophylactic milrinone improves cardiovascular or long-term clinical outcomes in preterm neonates who receive surgical patent ductus arteriosus (PDA) ligation. STUDY DESIGN: Retrospective review of 45 infants over a 4-year period that received a PDA ligation at one institution. Data were collected on morbidity and mortality outcomes for all infants as well as milrinone therapy perioperatively. RESULTS: Of the 45 infants that were studied 15 received milrinone in the perioperative period of PDA ligation and the remaining 30 infants did not receive milrinone. The use of milrinone showed no statistically significant improvement in acute markers of hemodynamic stability. There was also no statistically significant difference in morbidity and mortality outcomes in milrinone group compared to the non-milrinone group. CONCLUSION: Prophylactic milrinone use for premature infants following PDA ligation does not show a significant cardiovascular or long-term clinical benefit.
[Mh] Termos MeSH primário: Permeabilidade do Canal Arterial/cirurgia
Hemodinâmica/efeitos dos fármacos
Milrinona/uso terapêutico
Vasodilatadores/uso terapêutico
[Mh] Termos MeSH secundário: Peso ao Nascer
Distribuição de Qui-Quadrado
Idade Gestacional
Seres Humanos
Lactente Extremamente Prematuro
Recém-Nascido
Doenças do Prematuro
Ligadura
Estudos Retrospectivos
Estatísticas não Paramétricas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Vasodilator Agents); JU9YAX04C7 (Milrinone)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170720
[Lr] Data última revisão:
170720
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160414
[St] Status:MEDLINE
[do] DOI:10.1080/14767058.2016.1177720



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