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OLPRINONE, BUT NOT MILRINONE, IMPROVES HEPATOSPLANCHNIC CIRCULATION AFTER CARDIAC SURGERY

Iribe, G. MD; Yamada, H. MD; Matsunaga, A. MD; Yoshimura, N. MD

doi: 10.1097/00000539-199802001-00071
Abstracts of Posters Presented at the International Anesthesia Research Society; 72nd Clinical and Scientific Congress; Orlando, FL; March 7-11, 1998: Cardiovascular Anesthesia
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Division of Intensive Care Medicine, Kagoshima University, Kagoshima, Japan.

Abstract S71

Olprinone, a novel cardiotonic agent, and milrinone are potent phosphodiesterase III inhibitors. So far, the effect of these agents on the hepatosplanchnic circulation has not been well investigated. In the present study, we measured the hepatic venous oxygen saturation (ShvO2) and elucidated the effects of olprinone and milrinone on hepatosplanchnic oxygen dynamics in patients following cardiac surgery.

METHODS: With approval of our human ethical committee and informed consent, we included twenty patients undergoing elective cardiac surgery in this study. A 7.5 Fr. oximeter catheter was placed in the hepatic vein via right femoral vein under fluoroscopic guidance. The placement was completed before admission of ICU and the study was performed after obtaining stable systemic hemodynamics in the ICU. The patients were randomly assigned to two groups and administered either 0.3 [micro sign]g/kg/min of olprinone (OL group: n=10) or 0.5 [micro sign]g/kg/min of milrinone (ML group: n=10) for two hours. We did not change hemody namic interventions, including cathecholamines and vasodilators, throughout the present study. Arterial and hepatic venous blood gas analysis and hemody namic measurements using a pulmonary artery catheter were performed before and after the drug infusion. According these data, we calculated the change of the splanchnic blood flow (Qs) by Fick's Equation asfollows; Equation 1. Data were expressed as mean +/- SEM and analyzed by two way ANOVA. P<0.05 was considered significant.

RESULTS: Although both treatments showed similar increase of cardiac output, olprinone, but not milrinone, significantly increased ShvO2 (from 49.3 +/- 2.4 to 57.6 +/- 1.7% in OL group, and from 51.3 +/- 3.0 to 53.6 +/- 3.0% in ML group). In addition, the change of Qs in OL group was significantly greater than that in ML group (26.4 +/- 5.7 % in OL group, 14.3 +/- 5.1% in ML group).

CONCLUSIONS: Our results may indicate that olprinone facilitates the splanchnic blood flow compared with milrinone and olprinone is more beneficial than milrinone with regard to protecting splanchnic organs after cardiac surgery.

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REFERENCES

1. J Thorac Cardiovasc Surg 1982; 84: 800
    © 1998 International Anesthesia Research Society