PMID- 2025794
OWN - NLM
STAT- MEDLINE
DCOM- 19910611
LR  - 20131121
IS  - 0828-282X (Print)
IS  - 0828-282X (Linking)
VI  - 7
IP  - 1
DP  - 1991 Jan-Feb
TI  - A Canadian multicentre study of a 48 h infusion of milrinone in patients with 
      severe heart failure.
PG  - 5-10
AB  - Milrinone is a nonglycoside, nonsympathomimetic bipyridine with positive 
      inotropic and systemic vasodilator properties. In order to evaluate the efficacy 
      and safety of a short term infusion of milrinone, 105 patients with stable New 
      York Heart Association (NYHA) class III or IV heart failure received a loading 
      dose (50 micrograms/kg) and a 48 h continuous infusion (0.5 micrograms/kg/min). 
      Administration of the loading dose resulted in a 28% decrease in pulmonary 
      capillary wedge pressure (PCWP) (P less than 0.001), a 38% increase in cardiac 
      index (P less than 0.001), and a 34% increase in stroke volume index (P less than 
      0.001) within 15 mins. Milrinone infusion maintained an average 27% and 24% 
      reduction in PCWP during the first and second days, respectively (P less than 
      0.001). Cardiac index was 32% and 34% above baseline during the same intervals (P 
      less than 0.001). There were no clinically significant changes in heart rate or 
      mean arterial blood pressure during the study period. In a subset of 47 patients 
      who underwent Holter monitoring before and during infusion, a significant 
      increase in ventricular arrhythmias (premature ventricular complexes per hour, 
      ventricular couplets per hour and ventricular runs greater than or equal to 
      three) was demonstrated (P less than 0.0001). In general, milrinone was well 
      tolerated. Of the 105 patients entered, one died of an acute myocardial 
      infarction after premature termination of the infusion, and the infusion rate was 
      decreased in two others because of supraventricular arrhythmias. In patients with 
      severe heart failure, intravenous milrinone has significant beneficial 
      hemodynamic effects. ECG monitoring for arrhythmias is recommended during 
      milrinone infusion.
FAU - Pflugfelder, P W
AU  - Pflugfelder PW
AD  - University of Western Ontario, London.
FAU - O'Neill, B J
AU  - O'Neill BJ
FAU - Ogilvie, R I
AU  - Ogilvie RI
FAU - Beanlands, D S
AU  - Beanlands DS
FAU - Tanser, P H
AU  - Tanser PH
FAU - Tihal, H
AU  - Tihal H
FAU - Mizgala, H F
AU  - Mizgala HF
FAU - Fitchett, D H
AU  - Fitchett DH
FAU - Kostuk, W J
AU  - Kostuk WJ
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Can J Cardiol
JT  - The Canadian journal of cardiology
JID - 8510280
RN  - 0 (Cardiotonic Agents)
RN  - 0 (Pyridones)
RN  - 0 (Vasodilator Agents)
RN  - JU9YAX04C7 (Milrinone)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Arrhythmias, Cardiac/chemically induced
MH  - Cardiotonic Agents/*administration & dosage/adverse effects/pharmacology
MH  - Drug Evaluation
MH  - Electrocardiography, Ambulatory
MH  - Female
MH  - Heart Failure/*drug therapy
MH  - Hemodynamics/drug effects
MH  - Humans
MH  - Infusions, Intravenous
MH  - Male
MH  - Middle Aged
MH  - Milrinone
MH  - Pyridones/*administration & dosage/adverse effects/pharmacology
MH  - Vasodilator Agents/*administration & dosage/adverse effects/pharmacology
EDAT- 1991/01/01 00:00
MHDA- 1991/01/01 00:01
CRDT- 1991/01/01 00:00
PHST- 1991/01/01 00:00 [pubmed]
PHST- 1991/01/01 00:01 [medline]
PHST- 1991/01/01 00:00 [entrez]
PST - ppublish
SO  - Can J Cardiol. 1991 Jan-Feb;7(1):5-10.