[HSF] milrinone

[ICHFNO at aol.com]

We use it on almost every case we perform on pump and for  unifocalizations 
as well. There was a significant paper regarding milrinone  in neonates 
following intra-cardiac surgery, published a number of years ago in  Pediatric 
Critical Care, I will see if I can find it and send the reference. We  use a fairly 
high dose of 0.75-1.0/kg regularly on our cases, and the loading  dose is 
given on pump when the cross-clamp is removed. Every once in a blue-moon  you do 
get a substantial drop in SVR and need to increase flows and be prepared  to 
volume load when coming off, sometimes however the decrease is SVR is so  
significant that you have to counter it with nor-epinephrine. 
 
In those cases with severe pulmonary hypertension we routinely  use 1.0 
mcg/kg/minute and may increase the loading dose to 75 mcgs/kg on pump. 
 
Bill



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