Inhibitory Effect of Milrinone on Cytokine Production After Cardiopulmonary Bypass

Hayashida, Nobuhiko; Tomoeda, Hiroshi; Oda, Teiji; Tayama, Eiki; Kashikie, Hideyuki; Maruyama, Hidekazu; Kawara, Takemi; Aoyagi, Shigeaki

doi:10.1097/00002480-199903000-00080

Cited by 9 publications

(13 citation statements)

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“…Small randomized controlled trials [27,64,78,81] have examined the effects of milrinone on pHi, splanchnic blood flow and inflammatory markers. Two of these [78,81] suggested that the administration of milrinone may attenuate the fall in pHi associated with CPB and the increase in some markers of inflammation.…”

Section: Resultsmentioning

confidence: 99%

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et al. 2005

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266 CABG = coronary artery bypass grafting; CI = cardiac index; CPB = cardiopulmonary bypass; HR = heart rate; ICG = indocyanine green; ICU = intensive care unit; IMA = internal mammary artery; LCOS = low cardiac output syndrome; LVEF = left ventricular ejection fraction; MAP = mean arterial pressure; NO = nitric oxide; PDI = phosphodiesterase inhibitor; pHi = intramucosal pH; PVR = pulmonary vascular resistance; SVR = systemic vascular resistance; SVI = stroke volume index. Critical Care June 2005 Vol 9 No 3 Gillies et al. AbstractMany adult patients require temporary inotropic support after cardiac surgery. We reviewed the literature systematically to establish, present and classify the evidence regarding choice of inotropic drugs. The available evidence, while limited in quality and scope, supports the following observations; although all β-agonists can increase cardiac output, the best studied β-agonist and the one with the most favourable side-effect profile appears to be dobutamine. Dobutamine and phosphodiesterase inhibitors (PDIs) are efficacious inotropic drugs for management of the low cardiac output syndrome. Dobutamine is associated with a greater incidence of tachycardia and tachyarrhythmias, whereas PDIs often require the administration of vasoconstrictors. Other catecholamines have no clear advantages over dobutamine. PDIs increase the likelihood of successful weaning from cardiopulmonary bypass as compared with placebo. There is insufficient evidence that inotropic drugs should be selected for their effects on regional perfusion. PDIs also increase flow through arterial grafts, reduce mean pulmonary artery pressure and improve right heart performance in pulmonary hypertension. Insufficient data exist to allow selection of a specific inotropic agent in preference over another in adult cardiac surgery patients. Multicentre randomized controlled trials focusing on clinical rather than physiological outcomes are needed.

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Section: Resultsmentioning

confidence: 99%

“…Two of these [78,81] suggested that the administration of milrinone may attenuate the fall in pHi associated with CPB and the increase in some markers of inflammation. The remaining studies showed no difference.…”

Section: Resultsmentioning

confidence: 99%

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et al. 2005

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“…Murinone when administered with catecholamines has been shown to improve cardiovascular function in volume-resuscitated pédiatrie patients with septic shock (31). It suppresses the production of pro-inflammatory cytokines, such as interleukin (IL)-Iß, IL-6, tumor necrosis factor-a, and matrix metallopeptidase-9, by elevating cyclic adenosine monophosphate levels (14,15,32). It suppresses the production of pro-inflammatory cytokines, such as interleukin (IL)-Iß, IL-6, tumor necrosis factor-a, and matrix metallopeptidase-9, by elevating cyclic adenosine monophosphate levels (14,15,32).…”

Section: Discussionmentioning

confidence: 99%

Milrinone Therapy for Enterovirus 71-Induced Pulmonary Edema and/or Neurogenic Shock in Children

Khanh

Thoa

et al. 2013

Critical Care Medicine

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“…We are not certain as to the cause of this relationship between milrinone treatment and oxidative stress. Interestingly, Hayashide et al (27) have shown that milrinone inhibited proinflammatory cytokine formation (TNF-! ), thus dampening H-R injury.…”

Section: Discussionmentioning

confidence: 99%

Intestinal Hemodynamic Effects of Milrinone in Asphyxiated Newborn Pigs After Reoxygenation With 100% Oxygen

Joynt¹,

Bigam²,

Charrois

et al. 2009

Shock

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Neonatal asphyxia can result in poor perfusion, vasoconstriction, and decreased oxygen delivery in the intestine. Milrinone increases myocardial contractility and causes peripheral vasodilatation. We examined the dose-response of milrinone on the intestinal circulation, oxygen metabolism, and injury in a newborn piglet model of asphyxia-reoxygenation. Piglets (aged 1-3 days, weighing 1.5-2.3 kg) were acutely instrumented to measure superior mesenteric artery (SMA) flow and oxygen delivery. After stabilization, hypoxia (inspired oxygen concentration, 0.08-0.15) was induced for 2 h followed by reoxygenation with 100% O2 for 1 h then 21% O2 for 3 h. At 2 h of reoxygenation, saline or milrinone infusion at doses of 0.25, 0.5, or 0.75 microg/kg per min was given for 2 h in a blinded randomized fashion (n = 7 per group). Hemodynamic and oxygen transport parameters were analyzed at predefined time points. Intestinal tissue lactate concentrations, plasma milrinone levels, and intestinal glutathione redox status were determined at the end of the experiment. In the intestinal tract, milrinone significantly increased SMA flow and oxygen delivery while decreasing vascular resistance at a dose of 0.75 microg/kg per min (P < 0.05, ANOVA). A modest increase in SMA flow and oxygen delivery was found with milrinone at 0.5 microg/kg per min. Plasma milrinone levels correlated with SMA flow and vascular resistance (r = 0.5 and r = -0.6, respectively, P < 0.05). Intestinal lactate concentrations and histopathology were not significantly different among groups. Oxidized glutathione correlated with SMA vascular resistance and negatively with milrinone levels (r = 0.6 and r = -0.5, P < 0.05). When used to treat shock in a newborn model of asphyxia-reoxygenation, milrinone dose-dependently increases SMA flow and oxygen delivery with a significantly decreased SMA vascular resistance at higher doses.

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Inhibitory Effect of Milrinone on Cytokine Production After Cardiopulmonary Bypass

Cited by 9 publications

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Milrinone Therapy for Enterovirus 71-Induced Pulmonary Edema and/or Neurogenic Shock in Children

Intestinal Hemodynamic Effects of Milrinone in Asphyxiated Newborn Pigs After Reoxygenation With 100% Oxygen

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