Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/243857
Type: Artigo de periódico
Title: The Effect Of Milrinone On Splanchnic And Cerebral Perfusion In Infants With Congenital Heart Disease Prior To Surgery: An Observational Study
Author: Bianchi
Maria Otilia; Cheung
Po-Yin; Phillipos
Ernest; Aranha-Netto
Abimael; Joynt
Chloe
Abstract: Despite the advancement in the postoperative care of neonates with congenital heart disease (CHD), there is little information on preoperative management of systemic and regional hemodynamics, which may be related to outcomes. We aimed to determine the preoperative effect of milrinone, a phosphodiesterase III inhibitor, on cardiac output and splanchnic and cerebral perfusion in neonates with CHD. Neonates with CHD requiring cardiac surgery were enrolled in a prospective, single-blinded study once a clinical decision of starting milrinone (0.75 g/kg per minute intravenously) using institutional criteria was made. Demographic and clinical variables and outcomes were recorded. Combined cardiac output and measures of splanchnic (superior mesenteric and celiac arteries) and cerebral (anterior and middle cerebral arteries) perfusion were determined by Doppler studies at 0, 6, 24, and 48 h after milrinone infusion. Investigators were unaware of intervention time points and patients in analyzing blood flow measurements. Seventeen term (39.2 +/- 1.3 weeks) neonates were included with hypoplastic left-sided heart syndrome (78.5%) as the most common diagnosis. Combined cardiac output increased by 28% within 48 h (613 +/- 154 vs. 479 +/- 147 mL/kg per minute at baseline, P < 0.05). Superior mesenteric artery mean velocity increased at 6 h and throughout 48 h of milrinone infusion (P < 0.05). Peak and mean velocities at cerebral arteries increased with milrinone infusion (P < 0.05 approximate to 0.08), and the corresponding changes at celiac artery were modest. There were no significant changes in splanchnic and cerebral resistive and pulsatility indices during milrinone infusion. Milrinone increases cardiac output with concurrent effects on splanchnic and cerebral blood flows during the short-term preoperative use in neonates with CHD.
Subject: Cardiac-output Syndrome
Necrotizing Enterocolitis
Preterm Infants
Doppler Ultrasound
Mesenteric-artery
Dose-response
Newborn Pigs
Risk
Reoxygenation
Hemodynamics
Country: PHILADELPHIA
Editor: LIPPINCOTT WILLIAMS & WILKINS
Citation: The Effect Of Milrinone On Splanchnic And Cerebral Perfusion In Infants With Congenital Heart Disease Prior To Surgery: An Observational Study. Lippincott Williams & Wilkins, v. 44, p. 115-120 AUG-2015.
Rights: fechado
Identifier DOI: 10.1097/SHK.0000000000000388
Address: http://www.ncbi.nlm.nih.gov/pubmed/25895150
Date Issue: 2015
Appears in Collections:Unicamp - Artigos e Outros Documentos

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.