Inhaled Milrinone in Cardiac Surgery

Pharmacokinetic and Pharmacodynamic of Inhaled Milrinone in Cardiac Surgical Patients

The purpose of this study is to investigate the concentration-effect relationship of inhaled milrinone after prophylactic administration in cardiac surgical patients with preoperative pulmonary hypertension undergoing cardiopulmonary bypass.

Milrinone elimination will be verify with blood and urine samples analysis.

Inclusion Criteria:

• Patients scheduled for elective cardiac surgery under CPB

• High risk patients: NYHA class II-III

• Preoperative diagnostic of pulmonary hypertension:

  • Systolic pulmonary artery pressure (sPAP) > 35 mm Hg; or
  • Mean pulmonary artery pressure (mPAP) > 25 mm Hg; or
  • mAP/mPAP < 3.0 (after induction of anesthesia).

Exclusion Criteria:

• Open Heart Surgery
• Contraindication to transesophageal echocardiography (TEE)
• Hemodynamic instability before surgery
• Emergency surgery