Journal Article

Effects of milrinone on jugular bulb oxygen saturation and cerebrovascular carbon dioxide reactivity in patients undergoing coronary artery bypass graft surgery

Y. J. Oh, S. H. Kim, H. K. Shinn, C. S. Lee, Y. W. Hong and Y. L. Kwak

in BJA: British Journal of Anaesthesia

Published on behalf of the British Journal of Anaesthesia

Volume 93, issue 5, pages 634-638
Published in print November 2004 | ISSN: 0007-0912
Published online September 2004 | e-ISSN: 1471-6771 | DOI: http://dx.doi.org/10.1093/bja/aeh252
Effects of milrinone on jugular bulb oxygen saturation and cerebrovascular carbon dioxide reactivity in patients undergoing coronary artery bypass graft surgery

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Background. Jugular bulb oxygen saturation ([math]) is a surrogate marker for global cerebral oxygenation. The effect of milrinone on [math] and the cerebrovascular carbon dioxide reactivity (CCO2R) was investigated.

Methods. Thirty patients scheduled for coronary artery bypass graft surgery (CABG) were studied prospectively. After sternotomy, normoventilation (at T1; [math]=4.7–5.0 kPa) and hyperventilation (at T2; [math]=3.3–3.7 kPa) were induced and the changes in [math] ([math]) and [math] ([math]), and [math] (CCO2R) were measured. After normoventilation was re-established (at T3), milrinone 50 µg kg−1 was given (at T4), followed by hyperventilation (at T5), and [math], [math] and CCO2R were measured.

Results. After milrinone administration at normoventilation (T3 and T4), cardiac index and mixed venous oxygen saturation increased, while mean arterial pressure and systemic vascular resistance index decreased, without a significant change in [math]. Before milrinone administration (T1 and T2), hyperventilation decreased [math] and [math], and [math] showed positive linear correlation with [math]. After milrinone administration (T4 and T5), hyperventilation decreased [math] and [math], and [math] showed positive linear correlation with [math]. There was no significant difference in CCO2R before and after milrinone administration (13.3 (5.7)% kPa−1 and 12.3 (3.9)% kPa−1, respectively).

Conclusions. Although milrinone induced significant haemodynamic changes, [math] and CCO2R were unchanged during its administration.

Keywords: anaesthesia, cardiac; carbon dioxide, hypocarbia; monitoring, jugular bulb oxygen saturation; pharmacology, milrinone

Journal Article.  3525 words. 

Subjects: Anaesthetics

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