[HSF] milrinone

[Ben Bidstrup]

Lusitropy relates to the property of relaxation and is used in the 
main relating to the left ventricle.Failure is often called 
lusitropic failure. Diastolic relaxation is an active process 
requiring energy and calcium etc in its own right. Chapter 215 of 
Harrison gives some idea of the process.

>lusitropic - failure of relaxation - go to the gym and lift an inappropriate
>amount of weights and then your arms and legs have a loss of lusitrophy !!
>Prasanna
>
>On Dec 3, 2007 4:50 AM, Tea Acuff <tacuff at swbell.net> wrote:
>
>>  I tried to look up the meaning of lusitropic. Never could get a clear
>>  idea. I did find an interesting article for primary care physicians that
>>  claimed the treatment of diastolic heart failure (despite saying there was
>>  no clear defintion of diastolic heart failure) included the following:
>>
>>  Treatment by present guidelines....Evidence class A
>>  Then a list of multiple therapies including beta blockers, diuretics,
>>  revascularization, etc. ....all listed as evidence class C!
>>
>>  Imagine.
>>
>>  tea
>>
>>
>>  ----- Original Message ----
>>  From: Prasanna Simha M <prasannasimha at gmail.com>
>>  To: OpenHeart-L at lists.hsforum.com
>>  Sent: Sunday, December 2, 2007 8:59:01 AM
>>  Subject: Re: [HSF] milrinone
>>
>>  There are  articles and especially in the pediatric age group for eg it
>>  has
>>  been shown to be of benefit in the arterial switch and tetralogy etc.
>>  Basically I believe its best use is in patients with pulmonary
>>  hypertension
>>  and also RVdsfunction and in any condition where ventricular relaxation is
>>  impaired as it is virtually the only inotrope with lusitropic action. I
>>  would use it judiciously in these cases. Remember that itcan ccasue a fall
>>  in SVR and so adequate volume loading (best given on the pump and warn the
>>  perfusionist of a possible fall in the reservoir level -) In some cases it
>>  may be of benefit to combine it with Norepinephrine.
>>  Prasanna (in Leipzig at present)
>>
>>  On Dec 2, 2007 3:03 AM, james le <jamesle2007 at yahoo.com> wrote:
>>
>>  > Thanks Dr Prasanna,
>>  >
>>  >  Are there any studies which compared milrinone versus other inotropes
>>  > which showed the superiority of milrinone regarding outcomes?
>>  >
>>  > Prasanna Simha M <prasannasimha at gmail.com> wrote:
>>  >  Yes, works well in patients with dysfunctional RV's and stiff LV's. I
>>  use
>>  > them in patients with severe PH, RV dysfunction and tetrology patients.
>>  > They reduce inotropic usage and ICU time.
>>  > Prasanna
>>  >
>>  >
>>  > On 11/30/07, james le wrote:
>>  > >
>>  > > Is there any evidence of milrinone usage improving the out comes
>>  > > following cardiac surgery?
>>  > >
>>  > > [I work in public hospital where there is some on going discussion
>>  about
>>  > > its cost effectiveness]
>>  > >
>>  > >
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>>  > --
>>  > Prasanna Simha M
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>>
>>  --
>>  Prasanna Simha M
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>
>
>
>--
>Prasanna Simha M
>_______________________________________________
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-- 
Ben Bidstrup FRACS FRCSEd FEBCTS
Consultant Cardiothoracic Surgeon