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Effect of milrinone on short-term outcome of patients with myocardial dysfunction undergoing coronary artery bypass graft : A randomized controlled trial . BACKGROUND Myocardial dysfunction needing inotropic support is a typical complication after on-pump cardiac surgery . In this study , we evaluate the effect of milrinone on patients with ventricular dysfunction undergoing coronary artery bypass graft ( CABG ) . METHODS Seventy patients with impaired left ventricular function [ left ventricular ejection fraction ( LVEF ) < 35 % ] undergoing on-pump CABG were enrolled . Patients were randomized to receive either an intraoperative bolus of milrinone ( 50 microg/kg ) or saline as placebo followed by a 24-hour infusion of each agent ( 0.5 microg/kg/min ) . Hemodynamic parameters and transthoracic echocardiographic measurement of systolic and diastolic functions were the variables evaluated . RESULTS Serum levels of creatine phosphokinase ( CPK ) , the MB isoenzyme of creatine kinase ( CK-MB ) , occurrence of myocardial ischemia or infarction , and mean duration of using inotropic agents were significantly lower in the milrinone group ( p < 0.05 ) . There were no significant differences between the two groups regarding the development of ventricular arrhythmia , duration of cardiopulmonary bypass , intra-aortic balloon pump and inotropic support requirement , duration of mechanical ventilation , duration of intensive care unit stay and mortality rate . Although mean pre-operative LVEF was significantly lower in the milrinone group , there was no significant difference between post-operative LVEFs . CONCLUSIONS We suggest that perioperative administration of milrinone in patients undergoing on-pump CABG , especially those with low LVEF , is beneficial .
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Intervention_Pharmacological
milrinone
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Intervention_Pharmacological
milrinone
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Intervention_Surgical
coronary artery bypass graft ( CABG ) .
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Intervention_Pharmacological
intraoperative bolus of milrinone ( 50 microg/kg )
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Intervention_Control
as placebo
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Intervention_Pharmacological
milrinone
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Intervention_Pharmacological
milrinone
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Outcome_Physical
Hemodynamic parameters
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Outcome_Physical
transthoracic echocardiographic measurement of systolic and diastolic functions
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Outcome_Physical
Serum levels of creatine phosphokinase ( CPK )
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Outcome_Physical
the MB isoenzyme of creatine kinase ( CK-MB )
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Outcome_Physical
occurrence of myocardial ischemia or infarction
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Outcome_Physical
mean duration of using inotropic agents
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Outcome_Physical
development of ventricular arrhythmia
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Outcome_Physical
duration of cardiopulmonary bypass
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Outcome_Physical
intra-aortic balloon pump and inotropic support requirement , duration of mechanical ventilation
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Outcome_Physical
duration of intensive care unit stay
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Outcome_Mortality
mortality rate
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Participant_Condition
myocardial dysfunction undergoing coronary artery bypass graft
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Participant_Condition
ventricular dysfunction
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Participant_Condition
coronary artery bypass graft
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Participant_Sample-size
Seventy
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Participant_Condition
left ventricular ejection fraction