• J. Cardiothorac. Vasc. Anesth. · Apr 2017

    Intratracheal Milrinone Bolus Administration During Acute Right Ventricular Dysfunction After Cardiopulmonary Bypass.

    • Caroline Eva Gebhard, Georges Desjardins, Cathérine Gebhard, Paul Gavra, and André Y Denault.
    • Department of Anesthesiology and Critical Care, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
    • J. Cardiothorac. Vasc. Anesth. 2017 Apr 1; 31 (2): 489-496.

    ObjectiveTo evaluate intratracheal milrinone (tMil) administration for rapid treatment of right ventricular (RV) dysfunction as a novel route after cardiopulmonary bypass.DesignRetrospective analysis.SettingSingle-center study.ParticipantsThe study comprised 7 patients undergoing cardiac surgery who exhibited acute RV dysfunction after cardiopulmonary bypass.InterventionsAfter difficult weaning caused by cardiopulmonary bypass-induced acute RV dysfunction, milrinone was administered as a 5-mg bolus inside the endotracheal tube.Measurements And Main ResultsRV function improvement, as indicated by decreasing pulmonary artery pressure and changes of RV waveforms, was observed in all 7 patients. Adverse effects of tMil included dynamic RV outflow tract obstruction (2 patients) and a decrease in systemic mean arterial pressure (1 patient).ConclusionstMil may be an effective, rapid, and easily applicable therapeutic alternative to inhaled milrinone for the treatment of acute RV failure during cardiac surgery. However, sufficiently powered clinical trials are needed to confirm these findings.Copyright © 2017 Elsevier Inc. All rights reserved.

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