Journal of critical care
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Journal of critical care · Feb 2024
Review Meta AnalysisThe effect of intravenous milrinone in adult critically ill patients: A meta-analysis of randomized clinical trials.
Milrinone is widely used for enhancing myocardial contractility, however, there is inadequate data to suggest whether it is preferable to other inotropic agents in critically ill patients. To observe the effect of milrinone on prognosis in adult critically ill patients, we conducted this meta-analysis. ⋯ The meta-analysis showed when compared with control group, although no significant reduction in mortality and the incidence of myocardial infarction was found in the milrinone group, the incidence of ventricular arrhythmia decreased significantly in patients with cardiac surgery. More randomized controlled trials are needed to determine the reliable and conclusive evidence for milrinone's effects.
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Journal of critical care · Dec 2023
ReviewThe physiology of cardiac tamponade and implications for patient management.
Exceeding the limit of pericardial stretch, intrapericardial collections exert compression on the right heart and decrease preload. Compensatory mechanisms ensue to maintain hemodynamics in the face of a depressed stroke volume but are outstripped as disease progresses. ⋯ Invasive hemodynamics and echocardiographic findings inform on the physiologic effects. In this review, we describe tamponade physiology and implications for supportive care and effusion drainage.