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Sex dependent effects of cardiovascular agents on hemoglobin oxygen affinity - An ex-vivo experiment.
J Crit Care
February 2025
Department of Anaesthesiology and Intensive Care Medicine, Medical University of Innsbruck, Austria.
Background: Hemoglobin‑oxygen (Hb-O) affinity is an important determinant for oxygen delivery and oxygen extraction. Although cardiovascular agents such as noradrenaline, adrenaline, atropine, milrinone and levosimendan are widely used in intensive care units worldwide, nothing is known about their possible effects on Hb-O affinity.
Methods: In this experimental ex-vivo trial, venous blood samples were taken from 5 male and 6 female volunteers and incubated with the particular cardiovascular agents.
Laparoscopic cholecystectomy in a patient with Fontan circulation.
Can J Anaesth
October 2024
Department of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Article Synopsis
- Fontan circulation occurs when a baby is born with only one functioning cardiac ventricle, necessitating surgeries to manage blood flow between systemic and pulmonary circulation.
- A 39-year-old male patient with Fontan physiology and a pacemaker underwent elective laparoscopic cholecystectomy, requiring careful monitoring and management of hemodynamics during surgery.
- Intraoperative monitoring with transesophageal echocardiography and the use of inhaled milrinone improved blood flow and circulation tolerance, demonstrating the importance of tailored approaches in patients with complex cardiac conditions during laparoscopic procedures.
Clinical Interventions and Hemodynamic Monitoring in the Setting of Left Ventricular Systolic Heart Failure in Children: Insights From a Physiologic Simulator.
Am J Ther
September 2024
Section of Critical Care Medicine and Cardiology, Texas Children's Hospital, Houston, TX.
Article Synopsis
- Vasoactive and inotropic medications are commonly used in pediatric heart failure cases, but their effects are difficult to predict due to their complex interactions, with limited supporting evidence.
- This study aimed to assess the impact of these medications on cardiovascular parameters in children with low heart function using a computer simulator to model responses to various drug combinations.
- Results showed that dobutamine and milrinone consistently improved cardiac output, while epinephrine and norepinephrine had negative effects, indicating that milrinone and dobutamine are effective in enhancing systemic oxygen delivery, especially when used together.
Nitroglycerin versus milrinone for low central venous pressure in patients undergoing laparoscopic hepatectomy: a double-blinded randomized controlled trial.
BMC Anesthesiol
July 2024
Department of Anesthesiology, Jinhua Hospital Affiliated to Zhejiang University School of Medicine, Jinhua, Zhejiang Province, People's Republic of China.
Background: Conventional anesthesia used to reduce central venous pressure (CVP) during hepatectomy includes fluid restriction and vasodilator drugs, which can lead to a reduction in blood perfusion in vital organs and may counteract the benefits of low blood loss. In this study, we hypothesized that milrinone is feasible and effective in controlling low CVP (LCVP) during laparoscopic hepatectomy (LH). Compared with conventional anesthesia such as nitroglycerin, milrinone is beneficial in terms of intraoperative blood loss, surgical environment, hemodynamic stability, and patients' recovery.
View Article and Find Full Text PDFA retrospective observational study evaluating the association between vasoactive-inotropic score and mortality after major abdominal surgery.
Sci Rep
July 2024
Department of Anesthesiology, The First Affiliated Hospital, Guangxi Medical University, 6 Shuangyong Road, Nanning, 530021, China.
The relationship between VIS and mortality in patients undergoing major abdominal surgery remains unclear. This study aims to evaluate the association between VIS and both short-term and long-term all-cause mortality in patients undergoing major abdominal surgery, VIS was calculated (VIS = dopamine dose [µg/kg/min] + dobutamine dose [µg/kg/min] + 100 × epinephrine dose [µg/kg/min] + 10 × milrinone dose [µg/kg/min] + 10,000 × vasopressin dose [units/kg/min] + 100 × norepinephrine dose [µg/kg/min]) using the maximum dosing rates of vasoactives and inotropics within the first 24 h postoperative ICU admission. The study included 512 patients first admitted to the intensive care unit (ICU) who were administered vasoactive drugs after major abdominal surgery.
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