Elbaser Ibrahim Ibrahim Abd, El Aleem El Derie Ahmad Abd
Department of Anaesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Department of Cardiothoracic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Turk J Anaesthesiol Reanim. 2020 Apr;48(2):127-133. doi: 10.5152/TJAR.2019.91145. Epub 2019 Oct 4.
The aim of the present study was to evaluate the efficacy of inhaled milrinone in controlling pulmonary arterial hypertension (PAH) in paediatric cardiac surgery and its effect on weaning from cardiopulmonary bypass (CPB).
A total of 40 patients with congenital heart diseases complicated by PAH submitted to cardiac surgery requiring CPB were included in the present study and were randomly classified into the control group (n=20) who received intravenous milrinone 0.5 μg kg min and the inhaled group (n=20) who received inhaled milrinone 50 μg kg before initiation and just before weaning off CPB. Mean pulmonary artery pressure (mPAP), mean systemic arterial pressure (MAP), heart rate (HR), MAP/mPAP ratio, vasoactive drug requirements and time needed to wean the patients from CPB were collected.
mPAP and HR were significantly lower, and MAP and MAP/mPAP ratio were significantly higher in the inhaled group than in the control group. Vasoactive drug requirements were significantly lesser, and the time needed to wean the patients was significantly shorter in the inhaled group than in the control group.
Milrinone inhalation facilitated the weaning from CPB as it significantly reduced mPAP and maintained MAP with subsequently less needs for vasoactive drugs.
本研究旨在评估吸入米力农在小儿心脏手术中控制肺动脉高压（PAH）的疗效及其对体外循环（CPB）撤机的影响。
本研究纳入了40例患有先天性心脏病合并PAH且需要进行CPB心脏手术的患者，并将其随机分为对照组（n = 20），接受静脉注射米力农0.5μg/kg/min；吸入组（n = 20），在CPB开始前及即将撤机时接受吸入米力农50μg/kg。收集平均肺动脉压（mPAP）、平均体动脉压（MAP）、心率（HR）、MAP/mPAP比值、血管活性药物需求以及患者从CPB撤机所需时间。
吸入组的mPAP和HR显著低于对照组，而MAP和MAP/mPAP比值显著高于对照组。吸入组的血管活性药物需求显著较少，患者撤机所需时间显著短于对照组。
吸入米力农有助于CPB撤机，因为它能显著降低mPAP并维持MAP，从而减少对血管活性药物的需求。
