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Perioperative experience with amrinone.

J H Levy1, J M Bailey

  • 1Emory University School of Medicine, Division of Cardiothoracic Anesthesiology, Emory Clinic, Atlanta, Georgia.

European Journal of Anaesthesiology. Supplement
|January 1, 1992
PubMed
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Amrinone, a phosphodiesterase III inhibitor, can improve cardiac function in biventricular failure. Higher doses are recommended for cardiac surgery patients to achieve therapeutic levels and enhance cardiac output.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Congestive heart failure (CHF) leads to beta 1-adrenergic receptor down-regulation.
  • Amrinone is a phosphodiesterase fraction III inhibitor used for perioperative biventricular failure.
  • Amrinone can temporarily restore beta 1-adrenergic responses in CHF patients.

Purpose of the Study:

  • To evaluate amrinone's efficacy in managing perioperative biventricular dysfunction.
  • To determine optimal dosing strategies for amrinone in cardiac surgery.
  • To explore amrinone's role in pulmonary hypertension and its interaction with catecholamines.

Main Methods:

  • Investigated amrinone's mechanism of action, including vasodilation independent of other drug classes.
  • Analyzed amrinone's elimination half-life in volunteers and during cardiopulmonary bypass (CPB).

Related Experiment Videos

  • Examined the relationship between amrinone plasma concentration and cardiac output increases.

    • Main Results:

    • Amrinone's vasodilatory mechanism offers a therapeutic option for pulmonary hypertension.
    • Subtherapeutic amrinone plasma concentrations were observed 10 minutes after a 0.75 mg kg-1 dose in cardiac surgical patients.
    • Higher bolus doses (≥1.5 mg kg-1) are suggested for CPB weaning.
    • Concomitant administration with catecholamines shows additive effects on contractility and attenuates vasoconstriction.

    Conclusions:

    • Amrinone is a novel therapeutic agent for biventricular dysfunction in cardiac surgery.
    • Optimized dosing, including higher bolus and potential infusion, is crucial for therapeutic efficacy.
    • Amrinone combined with catecholamines offers synergistic benefits in managing cardiac surgical patients.