Why the study?
Does a continuous infusion of milrinone without a bolus improve haemodynamic stability in patients undergoing off-pump coronary artery bypass graft surgery?
Does a continuous infusion of milrinone without a bolus improve haemodynamic stability in patients undergoing off-pump coronary artery bypass graft surgery?
A continuous infusion of milrinone without a bolus dose improves haemodynamic stability and reduces the need for norepinephrine during off-pump coronary artery bypass graft surgery.
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May support milrinone for hemodynamic stability in off-pump CABG; hypothesis-generating and requires RCTs before practice change.
The haemodynamic effects of a continuous infusion of milrinone without an initial bolus dose were evaluated in patients undergoing off-pump coronary artery bypass graft surgery. After internal mammary artery harvest, milrinone 0.5 microg.min(-1).kg(-1) (29 patients) or a normal saline infusion (33 patients) was started and continued until all graft anastomoses were completed. Haemodynamic variables were recorded before application of the tissue stabiliser, at 1, 3, 5 and 10 min after the application of the stabiliser, and after its removal. The administration of a milrinone infusion was associated with a smaller decrease in cardiac output and mixed venous oxygen saturation during all the coronary artery anastomoses, with no severe complications and a decreased dose of norepinephrine infused to maintain systemic arterial pressure.
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Kwak et al. (2004) studied this question.
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