Influence Of Milrinone On Systemic Inflammation And In Perioperative Patients Undergoing Cardiac Valve Replacement

Objective To investigate the influence of milrinone on systemic inflammation in the perioperative cardiac valve replacement. Methods Twenty patients, scheduled for cardiac valve replacement were randomly divided into 2 groups: milrinone(M) and control(C) groups . Immediately after unclamping of aortic, a bolus of milrinone 50μg·kg^-1 was given in 10min ,which is followed by a continuous infusion of 0.5μg·kg^-1·min^-1 during operation in M group and persists to 24h after operation, and the same volume of saline was administrated in C group. The venous blood samples were obtained from the central vein at the following points: before operation(T₀), 30min after unclamping of aorta(T₁), 6h post-CPB (T₂) and 24h post-CPB (T₃). IL-6, and IL-10 were determined by enzyme-linked immunosorbent assay, CTn-I was determined by immunofluorescence assay. Results Compared with those at T₀, the levels of IL-6, IL-10 and CTn-I increased significantly from T₁ to T₃ (P<0.05) in both groups . IL-6 and IL-10 levels reached the peak at T₁. Compared with those in control group, IL-6 level decreased obviously (P<0.05) in milrinone group from T₁ to T₃, while IL-10 and CTn-I level increased markedly (P<0.05). Conclusions During CPB and cardiac valve replacement the systemic inflammation is obvious , reaches the peak 30 min after unclamping of aorta and persists to 24h after operation. Perioperative administration of low-dose milrinone is effective on myocardial preservation and against the inflammation.