[HSF] milrinone

[Prasanna Simha M]

Yes I have used it along with vasopressin too but if I need an additional
kick to the heart along with milrinone then I would prefer Noradrenaline
compared to vasopressin.
Vasopressin increases GFR in concentrations of 0.0003-0.0012 mics/kg/min
because it causes efferent arteriolar constriction but in higher doses will
cause afferent arteriolar constriction

On Dec 2, 2007 7:55 PM, < hgrmd at aol.com> wrote:

> Prasanna,
>  Agree with what you say.  However, I prefer vasopressin to raise the SVR.
>  It's probably less hard on the kidneys from what I've read.  However, who
> knows?
>
> Hal
> Sent from my Verizon Wireless BlackBerry
>
> -----Original Message-----
> From: "Prasanna Simha M" <prasannasimha at gmail.com >
>
> Date: Sun, 2 Dec 2007 15:59:01
> To:OpenHeart-L at lists.hsforum.com
> 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