Effects of milrinone on platelet aggregation in swine with pulmonary hypertension

Tanaka, Hiroyuki; Tajimi, Kimitaka; Miyajima, Yukari; Kazama, Mutsuyoshi; Kobayashi, Kunio

doi:10.1053/jcrc.2000.16464

Cited by 2 publications

(4 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In general, we observed either no or limited effects on blood gasses. This is in concordance with several other studies of the inodilators 10 – 12 , 14 , 22 , 27 , 34 , 35 and suggests against using blood gasses for evaluation of inodilators in acute PE.…”

Section: Discussionsupporting

confidence: 92%

“…27 Milrinone did, however, lower SVR and MAP which can be a potential clinical concern in patients with acute PE and low-to-normal blood pressure. These findings are comparable to other's findings on acute 11,12,[27][28][29] and chronic models. 22,30,31 As for levosimendan, RV afterload-reducing effects of milrinone seem to depend on pre-constricted conditions as mPAP and PVR are unaffected in normal pulmonary vasculature.…”

Section: Milrinone In Acute Pesupporting

confidence: 90%

“…Previous animal studies have mostly investigated a single drug 10 – 15 and more research is warranted to investigate the circulatory supportive effects of inodilators in acute PE. We aimed to investigate the hemodynamic profiles of levosimendan, milrinone, and dobutamine in a porcine model of autologous acute intermediate‐risk PE.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Levosimendan, milrinone, and dobutamine in experimental acute pulmonary embolism

Lyhne

Dragsbæk

Hansen³

et al. 2021

Pulm. circ.

View full text Add to dashboard Cite

Acute pulmonary embolism (PE) is a frequent condition in emergency medicine and potentially fatal. Cause of death is right ventricular (RV) failure due to increased RV afterload from both pulmonary vascular obstruction and vasoconstriction. Inodilators are interesting drugs of choice as they may improve RV function and lower its afterload. We aimed to investigate the cardiovascular effects of three clinically relevant inodilators: levosimendan, milrinone and dobutamine in acute PE. We conducted a randomized, blinded, animal study using 18 female pigs. Animals received large autologous PE until doubling of baseline mean pulmonary arterial pressure and were randomized to increasing doses of each inodilator. Effects were evaluated with bi-ventricular pressure-volume loop recordings, right heart catheterization and blood gas analyses. Induction of PE increased RV afterload and pulmonary pressure (p<0.05) causing RV dysfunction. Levosimendan and milrinone showed beneficial hemodynamic profiles by lowering RV pressures and volume (p<0.001) and improved RV function and cardiac output (p<0.05) without increasing RV mechanical work. Dobutamine increased RV pressure and function (p<0.01) but at a cost of increased mechanical work at the highest doses, showing an adverse hemodynamic profile. In a porcine model of acute PE, levosimendan and milrinone reduced RV afterload and improved RV function, whereas dobutamine at higher doses increased RV afterload and RV mechanical work. The study motivates clinical testing of inodilators in patients with acute PE and RV dysfunction.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Milrinone In Acute Pesupporting

confidence: 90%

See 1 more Smart Citation

Levosimendan, milrinone, and dobutamine in experimental acute pulmonary embolism

Lyhne

Dragsbæk

Hansen³

et al. 2021

Pulm. circ.

View full text Add to dashboard Cite

show abstract

“…Many medications, including iNO, milrinone, H 2 receptor blockers, prostaglandins, sildenafil, and antiplatelet agents, which are frequently used in patients on ECMO can alter qualitative platelet dysfunction ( 24 – 27 ). Limited experimental and clinical data studying the effect of these medications on qualitative platelet function in children on ECMO are present ( 28 – 30 ). There was no significant association between the use of iNO, milrinone, and ranitidine, and ADP-mediated platelet aggregation in our cohort.…”

Section: Discussionmentioning

confidence: 99%

Incidence of Platelet Dysfunction by Thromboelastography–Platelet Mapping in Children Supported with ECMO: A Pilot Retrospective Study

et al. 2016

View full text Add to dashboard Cite

BackgroundBleeding complications are common and decrease the odds of survival in children supported with extracorporeal membrane oxygenation (ECMO). The role of platelet dysfunction on ECMO-induced coagulopathy and resultant bleeding complications is not well understood. The primary objective of this pilot study was to determine the incidence and magnitude of platelet dysfunction according to thromboelastography (TEG®)–platelet mapping (PM) testing.MethodsRetrospective chart review of children <18 years old who required ECMO at a tertiary level hospital. We collected TEG®–PM and conventional coagulation tests data. We also collected demographic, medications, blood products administered, and clinical outcome data. We defined severe platelet dysfunction as <50% aggregation in response to an agonist.ResultsWe identified 24 out of 46 children on ECMO, who had TEG®–PM performed during the study period. We found the incidence of severe bleeding was 42% and mortality was 54% in our study cohort. In all samples measured, severe qualitative platelet dysfunction was more common for adenosine diphosphate (ADP)-mediated aggregation (92%) compared to arachidonic acid (AA)-mediated aggregation (75%) (p = 0.001). Also, ADP-mediated percent of platelet aggregation was significant lower than AA-mediated platelet aggregation [15% (interquartile range, IQR 2.8–48) vs. 49% (IQR 22–82.5), p < 0.001]. There was no difference in kaolin-activated heparinase TEG® parameters between the bleeding group and the non-bleeding group. Only absolute platelet count and TEG®–PM had increased predictive value on receiver operating characteristics analyses for severe bleeding and mortality compared to activated clotting time.ConclusionWe found frequent and severe qualitative platelet dysfunction on TEG®–PM testing in children on ECMO. Larger studies are needed to determine if the assessment of qualitative platelet function by TEG®–PM can improve prediction of bleeding complications for children on ECMO.

show abstract

Effects of milrinone on platelet aggregation in swine with pulmonary hypertension

Cited by 2 publications

References 18 publications

Levosimendan, milrinone, and dobutamine in experimental acute pulmonary embolism

Levosimendan, milrinone, and dobutamine in experimental acute pulmonary embolism

Incidence of Platelet Dysfunction by Thromboelastography–Platelet Mapping in Children Supported with ECMO: A Pilot Retrospective Study

Contact Info

Product

Resources

About