THE EFFECT OF INHALED MILRINONE ON PULMONARY ARTERIAL PRESSURE IN PATIENTS UNDERGOING CARDIAC SURGERY

Abstract

ABSTRACT
 Objective: To find out the effect of inhaled Milrinone on pulmonary arterial pressure in patients undergoing cardiac surgery.
 Methods: A randomized controlled trial was done at Peshawar Institute of Cardiology in 78 patients who had preoperative pulmonary hypertension and had undergone cardiac surgery between the ages of 3 months and 60 years. Divided into 2, group 1 received Intravenous (IV) Milrinone and group 2 received Inhalational (IN) Milrinone. MANOVA was used to compare the difference between two groups across six dependent variables i.e., Heart rate (HR), systolic arterial pressure (SAP), Central venous pressure (CVP), Systolic pulmonary arterial pressure (SPAP), Diastolic pulmonary arterial pressure (DPAP) and Diastolic pulmonary arterial pressure (MPAP) at three stages; baseline, end of nebulization, and after cardiopulmonary bypass (labeled as stages 1,2 and3).
 Intraoperative complications like weaning from cardiac bypass (CBP) machine, use of vasopressor, insertion of intra-aortic balloon pump (IABP), and cardiopulmonary re-initiation were also observed in both the groups. Analysis of the data was done through SPSS-23.
 Results: In a total of 78 patients (39 in each group), an insignificant change was observed regarding the effects of IN Milrinone on HR, SAP, and CVP whereas significant effects of Inhaled Milrinone on SPAP, DPAP, and MPAP were observed (P-values <0.05).
 Conclusion: The use of inhaled Milrinone was beneficial in patients with pulmonary hypertension in the prevention of Intraoperative complications like difficulty in weaning from CPB, insertion of IABP, and use of vasopressors, while CPB re-initiation was observed less in patients with inhalational milrinone as compared with intravenous administration while reducing their length of stay in ICU.
 Key Words: inhaled Milrinone, pulmonary artery pressure, cardiac surgery.