Inhaled milrinone in cardiac surgical patients: a pilot randomized controlled trial of jet vs. mesh nebulization.
Administration, Inhalation
Aged
Cardiac Surgical Procedures
/ methods
Cardiopulmonary Bypass
/ methods
Female
Hemodynamics
/ drug effects
Humans
Hypertension, Pulmonary
/ drug therapy
Male
Milrinone
/ administration & dosage
Nebulizers and Vaporizers
Pilot Projects
Vasodilator Agents
/ administration & dosage
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
07 02 2020
07 02 2020
Historique:
received:
11
09
2019
accepted:
22
01
2020
entrez:
9
2
2020
pubmed:
9
2
2020
medline:
13
11
2020
Statut:
epublish
Résumé
Inhaled milrinone administered before cardiopulmonary bypass (CPB) reduces the severity of pulmonary hypertension during cardiac surgery. However, milrinone pharmacokinetics has not been determined for this route of administration. The objective of this study was to investigate inhaled milrinone dosing in vitro and early plasma concentrations in vivo after jet and mesh nebulization. Twelve pulmonary hypertensive patients scheduled for cardiac surgery were randomized to receive milrinone (5 mg) by inhalation before CPB using a jet or mesh nebulizer. In vitro experiments were conducted to determine the inhaled dose delivered with either jet or mesh nebulization. In vivo experiments involved hemodynamic monitoring and blood samples drawn from patients for the first 15 min after the end of inhalation to determine early plasma concentrations. After mesh nebulization, the mean in vitro inhaled dose was almost 3-fold higher compared to jet nebulization (46.4% vs 16.6% for mesh and jet, respectively; mean difference, 29.8%; 95% CI, 14.1 to 45.5; P = 0.006). Consistent with this, the early plasma concentrations in vivo were also 2-3 fold higher after mesh nebulization (P = 0.002-0.005). After inhalation (jet or mesh nebulization), milrinone early plasma concentrations remained within the therapeutic range. No systemic hypotension was reported in our patients.
Identifiants
pubmed: 32034202
doi: 10.1038/s41598-020-58902-x
pii: 10.1038/s41598-020-58902-x
pmc: PMC7005849
doi:
Substances chimiques
Vasodilator Agents
0
Milrinone
JU9YAX04C7
Types de publication
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2069Références
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