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

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), Cen-tral venous pressure (CVP), Systolic pulmonary arterial pressure (SPAP), Diastolic pulmonary arterial pressure (DPAP) and mean pulmonary arterial pressure (MPAP) at three stages; baseline, end of nebulization, and after cardiopulmonary bypass (labeled as stages 1,2 and 3). Intraoperative complications like weaning from cardiaopulmonary bypass (CPB) 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 Mil-rinone 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 Intraop-erative 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.