What is a milrinone drip used for?
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.
What is the mechanism of action of milrinone in heart failure patients?
It is a phosphodiesterase 3 inhibitor that works to increase the heart’s contractility and decrease pulmonary vascular resistance. Milrinone also works to vasodilate which helps alleviate increased pressures (afterload) on the heart, thus improving its pumping action.
Is milrinone a continuous infusion?
Milrinone is a phosphodiesterase 3 inhibitor with both positive inotropic and vasodilator properties. Administered as a continuous infusion, milrinone is indicated for the short-term treatment of patients with acute decompensated heart failure.
How long can you be on milrinone drip?
Fifty-one patients successfully began β-blocker therapy while on intravenous milrinone. Oral medical therapy was maximized when possible. The mean duration of milrinone treatment in this combination-treatment group was 269 days (range, 14–1,026 days). Functional class improved from IV to II–III with milrinone therapy.
Does milrinone decrease heart rate?
Milrinone increases cardiac index with reductions in arterial pressure, left ventricular end-diastolic pressure, and PVR. Heart rate can increase, although this is not a consistent response and bradycardia can also occur.
Does milrinone increase cardiac output?
At lower filling pressures, milrinone increases cardiac output more markedly than equally hypotensive doses of pure vasodilators. This response is accompanied by an increased left ventricular dP/dtmax and a shift in the left ventricular performance is associated with a lower myocardial energy requirement.
How do you titrate a milrinone drip?
50 mcg/kg IV load, then 0.33 to 0.5 mcg/kg/minute continuous IV infusion, initially. Titrate by 0.33 mcg/kg/minute every 2 hours until clinical response is attained. Max: 1 mcg/kg/minute. Avoid loading dose to minimize the risk of hypotension.
Which adverse cardiac effect may occur in a patient receiving intravenous milrinone?
The most common adverse effect of milrinone is arterial hypotension, though this is often a desired effect. Milrinone use is an independent risk factor for the development of atrial fibrillation after cardiac surgery, but the incidence is less than with dobutamine.
How long can a patient stay on milrinone?
Does milrinone need a central line?
Adult Critical Care Protocol: May be administered by IV infusion by a nurse in Adult Critical Care. Each loading dose and infusion rate must be ordered by physician; nurses are not approved to titrate milrinone. Must be administered via central venous access device.
Does milrinone prolong life?
According to Stuart, inotropic drugs are both life-prolonging and life-shortening, depending on one’s perspective. In the short term, dobutamine and milrinone can prolong life. They can add days or weeks to the patient’s life.
What is milrinone used for?
Milrinone is a medication indicated for cardiac support in patients with acute heart failure, pulmonary hypertension, or chronic heart failure.
How many milligrams of milrinone do you give for heart failure?
Milrinone dosing information Usual Adult Dose for Congestive Heart Failure: Loading dose: 50 mcg/kg IV over 10 minutes. Maintenance infusion: 0.375 to 0.75 mcg/kg/min.
Does milrinone help with β-blocker up-titration?
Milrinone has been used widely in the treatment of refractory systolic impairment, with mixed results; however, recent evaluations have shown that milrinone may aid in β-blocker up-titration and improve patients’ functional status.
What are the side effects of milrinone?
Milrinone side effects. Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Tell your caregivers at once if you have: chest pain; a light-headed feeling, like you might pass out;