The administration of milrinone through inhalation has been studied in only a few animal and human studies. Compared to the intravenous administration, inhaled milrinone has been shown to reduce pulmonary artery pressure without systemic hypotension. Therefore, this approach could represent an alternative to nitric oxide. This current state of knowledge of intravenous and inhaled milrinone is presented and summarized.
Baim DS, McDowell AV, Cherniles J, et al.Evaluation of a new bipyridine inotropic agent—milrinone—in patients with severe congestive heart failure. N Engl J Med. 1983; 309: 748-756.
2.
Colucci WS, Wright RF, Jaski BE, et al.Milrinone and dobutamine in severe heart failure: differing hemodynamic effects and individual patient responsiveness. Circulation. 1986;73: III175-III183.
3.
Gage J, Rutman H, Lucido D, et al.Additive effects of dobutamine and amrinone on myocardial contractility and ventricular performance in patients with severe heart failure. Circulation. 1986;74: 367-373.
4.
Omae T, Kakihana Y, Mastunaga A, et al.Hemodynamic changes during off-pump coronary artery bypass anastomosis in patients with coexisting mitral regurgitation: improvement with milrinone. Anesth Analg. 2005; 101: 2-8.
5.
Hoffman TM, Wernovsky G, Atz AM, et al.Efficacy and safety of milrinone in preventing low cardiac output syndrome in infants and children after corrective surgery for congenital heart disease. Circulation. 2003;107: 996-1002.
6.
Kikura M, Levy JH, Michelsen LG, et al.The effect of milrinone on hemodynamics and left ventricular function after emergence from cardiopulmonary bypass. Anesth Analg. 1997;85: 16-22.
7.
Lobato EB, Florete O, Jr., Bingham HL.A single dose of milrinone facilitates separation from cardiopulmonary bypass in patients with pre-existing left ventricular dys-function. Br J Anaesth. 1998;81: 782-784.
8.
Iwagaki T, Irie J, Ijichi K, et al.The effects of milrinone on hemodynamics in patients undergoing cardiac surgery. Masui. 2001;50: 360-364.
9.
Shibata T, Suehiro S, Sasaki Y, et al.Slow induction of milrinone after coronary artery bypass grafting. Ann Thorac Cardiovasc Surg. 2001;7: 23-27.
10.
Kim JH, Ham BM, Kim YL, et al.Prophylactic milrinone during OPCAB of posterior vessels: implication in angina patients taking beta-blockers. Eur J Cardiothorac Surg. 2003;24: 770-776.
11.
Maslow AD, Regan MM, Schwartz C, et al.Inotropes improve right heart function in patients undergoing aortic valve replacement for aortic stenosis. Anesth Analg. 2004;98: 891-902.
12.
Hayashida N, Tomoeda H, Oda T, et al.Inhibitory effect of milrinone on cytokine production after cardiopulmonary bypass. Ann Thorac Surg. 1999;68: 1661-1667.
13.
Janelle GM, Urdaneta F, Blas ML, et al.Inhibition of phosphodiesterase type III before aortic cross-clamping preserves intramyocardial cyclic adenosine monophosphate during cardiopulmonary bypass. Anesth Analg. 2001;92: 1377-1383.
14.
Yamada T, Takeda J, Katori N, et al.Hemodynamic effects of milrinone during weaning from cardiopulmonary bypass: comparison of patients with a low and high preby-pass cardiac index. J Cardiothorac Vasc Anesth. 2000;14: 367-373.
15.
Solina A, Papp D, Ginsberg S, et al.A comparison of inhaled nitric oxide and milrinone for the treatment of pulmonary hypertension in adult cardiac surgery patients. J Cardiothorac Vasc Anesth. 2000;14: 12-17.
16.
Denault AY, Chaput M, Couture P, et al.Dynamic right ventricular outflow tract obstruction in cardiac surgery. J Thorac Cardiovasc Surg. 2006 (In press)
17.
Cuffe MS, Califf RM, Adams KF, Jr, et al.Short-term intravenous milrinone for acute exacerbation of chronic heart failure: a randomized controlled trial. JAMA. 2002;287: 1541-1547.
18.
Rathmell JP, Prielipp RC, Butterworth JF, et al.A multi-center, randomized, blind comparison of amrinone with milrinone after elective cardiac surgery. Anesth Analg. 1998;86: 683-690.
19.
Feneck RO, Sherry KM, Withington PS, et al.Comparison of the hemodynamic effects of milrinone with dobuta-mine in patients after cardiac surgery. J Cardiothorac Vasc Anesth. 2001;15: 306-315.
20.
Khazin V, Kaufman Y, Zabeeda D, et al.Milrinone and nitric oxide: combined effect on pulmonary artery pressures after cardiopulmonary bypass in children. J Cardiothorac Vasc Anesth. 2004;18: 156-159.
21.
Chen EP, Craig DM, Bittner HB.Pharmacological strategies for improving diastolic dysfunction in the setting of chronic pulmonary hypertension. Circulation. 1998;97: 1606-1612.
22.
Marcus JT, Vonk NA, Roeleveld RJ, et al.Impaired left ventricular filling due to right ventricular pressure overload in primary pulmonary hypertension: noninvasive monitoring using MRI. Chest. 2001;119: 1761-1765.
23.
Monrad ES, McKay RG, Baim DS, et al.Improvement in indexes of diastolic performance in patients with congestive heart failure treated with milrinone. Circulation. 1984;70: 1030-1037.
24.
Lobato EB, Gravenstein N, Martin TD.Milrinone, not epinephrine, improves left ventricular compliance after cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2000;14: 374-377.
25.
Shi Y, Denault AY, Couture P, et al.Bi-ventricular diastolic filling patterns after coronary artery bypass graft surgery. J Thorac Cardiovasc Surg. 2006, (in press).
26.
Rakowski H, Appleton C, Chan KL, et al.Canadian consensus recommendations for the measurement and reporting of diastolic dysfunction by echocardiography: from the Investigators of Consensus on Diastolic Dysfunction by Echocardiography. J Am Soc Echocardiogr. 1996;9: 736-760.
27.
Khouri SJ, Maly GT, Suh DD, et al.A practical approach to the echocardiographic evaluation of diastolic function. J Am Soc Echocardiogr. 2004;17: 290-297.
28.
Lobato EB, Willert JL, Looke TD, et al.Effects of milri-none versus epinephrine on left ventricular relaxation after cardiopulmonary bypass following myocardial revascularization: assessment by color m-mode and tissue Doppler. J Cardiothorac Vasc Anesth. 2005;19: 334-339.
29.
Hayashida N, Kawara T, Tomoeda H, et al.Influence of milrinone on internal mammary artery grafts. Kyobu Geka. 1999;52: 993-997.
30.
Lobato EB, Urdaneta F, Martin TD, et al.Effects of milrinone versus epinephrine on grafted internal mammary artery flow after cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2000;14: 9-11.
31.
Zabeeda D, Medalion B, Jackobshvilli S, et al.Comparison of systemic vasodilators: effects on flow in internal mammary and radial arteries. Ann Thorac Surg. 2001;71: 138-141.
32.
Mollhoff T, Loick HM, Van Aken H, et al.Milrinone modulates endotoxemia, systemic inflammation, and subsequent acute phase response after cardiopulmonary bypass (CPB). Anesthesiology. 1999;90: 72-80.
33.
McNicol L, Andersen LW, Liu G, et al.Markers of splanchnic perfusion and intestinal translocation of endotoxins during cardiopulmonary bypass: effects of dopamine and milrinone. J Cardiothorac Vasc Anesth. 1999;13: 292-298.
34.
Yamaura K, Okamoto H, Akiyoshi K, et al.Effect of low-dose milrinone on gastric intramucosal pH and systemic inflammation after hypothermic cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2001;15: 197-203.
35.
Kikura M, Lee MK, Safon RA, et al.The effects of milrinone on platelets in patients undergoing cardiac surgery. Anesth Analg. 1995;81: 44-48.
36.
Kikura M, Sato S.Effects of preemptive therapy with milrinone or amrinone on perioperative platelet function and haemostasis in patients undergoing coronary bypass grafting. Platelets. 2003;14: 277-282.
37.
Doolan LA, Jones EF, Kalman J, et al.A placebo-controlled trial verifying the efficacy of milrinone in weaning high-risk patients from cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 1997;11: 37-41.
38.
Felker GM, Benza RL, Chandler AB, et al.Heart failure etiology and response to milrinone in decompensated heart failure: results from the OPTIME-CHF study. J Am Coll Cardiol. 2003;41: 997-1003.
39.
Tuman KJ, McCarthy RJ, March RJ, et al.Morbidity and duration of ICU stay after cardiac surgery. A model for preoperative risk assessment. Chest. 1992;102: 36-44.
40.
Tremblay NA, Hardy JF, Perrault J, et al.A simple classification of the risk in cardiac surgery: the first decade. Can J Anaesth. 1993;40: 103-111.
41.
Reich DL, Bodian CA, Krol M, et al.Intraoperative hemodynamic predictors of mortality, stroke, and myocardial infarction after coronary artery bypass surgery. Anesth Analg. 1999;89: 814-822.
42.
Bernstein AD, Parsonnet V.Bedside estimation of risk as an aid for decision-making in cardiac surgery. Ann Thorac Surg. 2000;69: 823-828.
43.
Malouf JF, Enriquez-Sarano M, Pellikka PA, et al.Severe pulmonary hypertension in patients with severe aortic valve stenosis: clinical profile and prognostic implications. J Am Coll Cardiol. 2000;40: 789-795.
44.
Robitaille A, Denault AY, Couture P, et al.Importance of relative pulmonary hypertension in cardiac surgery: the mean systemic-to-pulmonary artery pressure ratio. J Cardiothorac Vasc Anesth. 2006;20: 331-339.
45.
Carricart M, Denault AY, Couture P, et al.Incidence and significance of abnormal hepatic venous Doppler flow velocities before cardiac surgery. J Cardiothorac Vasc Anesth. 2005;19: 751-758.
46.
Erickson KW, Costanzo-Nordin MR, O’Sullivan EJ, et al.Influence of preoperative transpulmonary gradient on late mortality after orthotopic heart transplantation. J Heart Transplant. 1990;9: 526-537.
47.
Haraldsson A, Kieler-Jensen N, Nathorst-Westfelt U, et al.Comparison of inhaled nitric oxide and inhaled aerosolized prostacyclin in the evaluation of heart transplant candidates with elevated pulmonary vascular resistance. Chest. 1998;114: 780-786.
48.
Haraldsson A, Kieler-Jensen N, Ricksten SE.The additive pulmonary vasodilatory effects of inhaled prostacyclin and inhaled milrinone in postcardiac surgical patients with pulmonary hypertension. Anesth Analg. 2001;93: 1439-1445.
49.
Kwak YL, Lee CS, Park YH, et al.The effect of phenylephrine and norepinephrine in patients with chronic pulmonary hypertension. Anaesthesia. 2002;57: 9-14.
50.
Therrien J, Dore A, Gersony W, et al.CCS Consensus Conference 2001 update: recommendations for the management of adults with congenital heart disease. Part I. Can J Cardiol. 2001;17: 940-959.
51.
Hache M, Denault AY, Bélisle S, et al.Inhaled epoprostenol (prostacyclin) and pulmonary hypertension before cardiac surgery. J Thorac Cardiovasc Surg. 2003;125: 642-649.
52.
Wan S, LeClerc JL, Vincent JL.Inflammatory response to cardiopulmonary bypass: mechanisms involved and possible therapeutic strategies. Chest. 1997;112: 676-692.
53.
Kolff WJ, Effler DB, Groves LK, Hughes CR, McCormack LJ.Pulmonary complications of open-heart operations: their pathogenesis and avoidance. Cleve Clin Q. 1958;25: 65-83.
54.
Ng CS, Wan S, Yim AP, et al.Pulmonary dysfunction after cardiac surgery. Chest. 2002;121: 1269-1277.
55.
Carteaux JP, Roux S, Siaghy M, et al.Acute pulmonary hypertension after cardiopulmonary bypass in pig: the role of endogenous endothelin. Eur J Cardiothorac Surg. 1999;15: 346-352.
56.
Shafique T, Johnson RG, Dai HB, et al.Altered pulmonary microvascular reactivity after total cardiopulmonary bypass. J Thorac Cardiovasc Surg. 1993;106: 479-486.
57.
Dorman BH, Bond BR, Clair MJ, et al.Temporal synthesis and release of endothelin within the systemic and myocardial circulation during and after cardiopulmonary bypass: relation to postoperative recovery. J Cardiothorac Vasc Anesth. 2000;14: 540-545.
58.
Dorman BH, New RB, Bond BR, et al.Myocyte endothelin exposure during cardioplegic arrest exacerbates contractile dysfunction after reperfusion. Anesth Analg. 2000;90: 1080-1085.
59.
Goldberg AT, Bond BR, Mukherjee R, et al.Endothelin receptor pathway in human left ventricular myocytes: relation to contractility. Ann Thorac Surg2000;69: 711-715.
60.
Bond BR, Dorman BH, Clair MJ, et al.Endothelin-1 during and after cardiopulmonary bypass: association to graft sensitivity and postoperative recovery. J Thorac Cardiovasc Surg. 2001;122: 358-364.
61.
Dorman BH, Kratz JM, Multani MM, et al.A prospective, randomized study of endothelin and postoperative recovery in off-pump versus conventional coronary artery bypass surgery. J Cardiothorac Vasc Anesth. 2004;18: 25-29.
62.
Surgenor SD, O’Connor GT, Lahey SJ.Predicting the risk of death from heart failure after coronary artery bypass graft surgery. Anesth Analg. 2001;92: 596-601.
63.
Davila-Roman VG, Waggoner AD, Hopkins WE.Right ventricular dysfunction in low output syndrome after cardiac operations: assessment by transesophageal echocardiography. Ann Thorac Surg. 1995;60: 1081-1086.
64.
Trachte AL, Lobato EB, Urdaneta F, et al.Oral sildenafil reduces pulmonary hypertension after cardiac surgery. Ann Thorac Surg. 2005;79: 194-197.
65.
De Wet CJ, Affleck DG, Jacobsohn E, et al.Inhaled prostacyclin is safe, effective, and affordable in patients with pulmonary hypertension, right heart dys-function, and refractory hypoxemia after cardiothoracic surgery. J Thorac Cardiovasc Surg. 2004;127: 1058-1067.
66.
Solina AR, Ginsberg SH, Papp D, et al.Dose response to nitric oxide in adult cardiac surgery patients. J Clin Anesth2001;13: 281-286.
67.
Lamarche Y, Malo O, Thorin E, et al.Inhaled but not intravenous milrinone prevents pulmonary endothelial dysfunction after cardiopulmonary bypass. J Thorac Cardiovasc Surg. 2005;130: 83-92.
68.
Fortier S, DeMaria RG, Lamarche Y, et al.Inhaled prostacyclin reduces cardiopulmonary bypass-induced pulmonary endothelial dysfunction via increased cyclic adenosine monophosphate levels. J Thorac Cardiovasc Surg. 2004;128: 109-116.
69.
Sablotzki A, Starzmann W, Scheubel R, et al.Selective pulmonary vasodilation with inhaled aerosolized milri-none in heart transplant candidates: la vasodilatation pulmonaire selective avec l’inhalation de milrinone en aerosol chez des candidats a la greffe cardiaque. Can J Anaesth. 2005;52: 1076-1082.
70.
Rich GF, Murphy GD, Jr., Roos CM, et al.Inhaled nitric oxide. Selective pulmonary vasodilation in cardiac surgical patients. Anesthesiology. 1993;78: 1028-1035.
71.
Kieler-Jensen N, Lundin S, Ricksten SE.Vasodilator therapy after heart transplantation: effects of inhaled nitric oxide and intravenous prostacyclin, prostaglandin E1, and sodium nitroprusside. J Heart Lung Transplant. 1995;14: 436-443.
De Hert SG, Moens MM, Jorens PG, et al.Comparison of two different loading doses of milrinone for weaning from cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 1995;9: 264-271.
74.
Hamada Y, Kawachi K, Yamamoto T, et al.Effects of single administration of a phosphodiesterase III inhibitor during cardiopulmonary bypass: comparison of milri-none and amrinone. Jpn Circ J. 1999;63: 605-609.
75.
Sha K, Shimokawa M, Ishimaru K, et al.Differences in hemodynamic effects of amrinone, milrinone and olprinon after cardiopulmonary bypass in valvular cardiac surgery. Masui. 2000;49: 981-986.
76.
Lobato EB, Janelle GM, Urdaneta F, et al.Comparison of milrinone versus nitroglycerin, alone and in combination, on grafted internal mammary artery flow after cardiopulmonary bypass: effects of alpha-adrenergic stimulation. J Cardiothorac Vasc Anesth. 2001;15: 723-727.
77.
Mollhoff T, Schmidt C, Van Aken H, et al.Myocardial ischaemia in patients with impaired left ventricular function undergoing coronary artery bypass grafting—milrinone versus nifedipin. Eur J Anaesth. 2002;19: 796-802.
78.
Kikura M, Sato S.The efficacy of preemptive milrinone or amrinone therapy in patients undergoing coronary artery bypass grafting. Anesth Analg. 2002;94: 22-30.
79.
Kwak YL, Oh YJ, Kim SH, et al.Efficacy of preemptive milrinone in off-pump coronary artery bypass surgery: comparison between patients with a low and normal pre-graft cardiac index. Eur J Cardiothorac Surg. 2004;26: 687-693.
80.
Kwak YL, Oh YJ, Shinn HK, et al.Haemodynamic effects of a milrinone infusion without a bolus in patients undergoing off-pump coronary artery bypass graft surgery. Anaesthesia. 2004;59: 324-331.
