Why would you use milrinone over dobutamine?

Milrinone was introduced as an agent which, compared to dobutamine, cause reduced left and right heart filling pressures due to its greater reduction in vascular resistance, and thus superior to dobutamine in treatment of low cardiac output syndrome following cardiac surgery [30, 31].

When do you use milrinone vs dobutamine?

As milrinone is renally eliminated, significant renal dysfunction may have led clinicians to choose dobutamine over milrinone. Dobutamine patients had a higher incidence of history of stroke and coronary artery disease, as well as higher troponin and NT-proBNP levels at baseline when compared with the milrinone group.

Is dobutamine the same as milrinone?

Milrinone is a phosphodiesterase 3 inhibitor that increases cardiac inotropy, lusitropy, and peripheral vasodilatation. In contrast, dobutamine is a synthetic catecholamine that acts as a β1- and β2-receptor agonist and improves blood pressure by increasing cardiac output.

Can you use milrinone and dobutamine together?

The combined use of both I.V. milrinone and dobutamine has been used clinically and may have the advantage of improving hemodynamics better than either drug alone.

How does milrinone cause vasodilation?

It functions by improving cardiac contractility (inotropy), cardiac relaxation (lusitropy), and inducing vasodilation and has the overall effect of increased cardiac output, improvement of left ventricle-arterial coupling, and enhanced cardiac mechanical efficiency.

Does milrinone cause thrombocytopenia?

Although amrinone produces thrombocytopenia, no information is available regarding the acute effects of milrinone on platelets. Therefore, we evaluated the effects of milrinone on platelet number and function in cardiac surgical patients.

Does milrinone increase or decrease BP?

Milrinone is a vasodilator that works by relaxing the muscles in your blood vessels to help them dilate (widen). This lowers blood pressure and allows blood to flow more easily through your veins and arteries. Milrinone is used as a short-term treatment for life-threatening heart failure.

Does milrinone decrease afterload?

Effects of milrinone on myocardial oxygen demand Milrinone and dobutamine seem to be equivalent in increasing cardiac index, but milrinone does so without increasing myocardial oxygen consumption, likely because it also decreases afterload (and thus ventricular workload).

Does milrinone cause Vtach?

Cardiovascular side effects have included ventricular arrhythmias (12%), ventricular ectopic activity (8%), supraventricular arrhythmias (3.8%), sustained and nonsustained ventricular tachycardia (1% and 2.8%, respectively), ventricular fibrillation (0.2%), and atrial fibrillation.