Circulating cyclic adenosine monophosphate concentrations in milrinone treated paediatric patients after congenital heart surgery.
Circulating cyclic adenosine monophosphate concentrations in milrinone treated paediatric patients after congenital heart surgery.
复制标题
先天性心脏手术后，米尔林酮治疗的小儿患者循环环状腺苷浓度。
DOI：
10.1017/s1047951121000251
复制
发表时间：
2021-09
影响因子：
1
通讯作者：
Miyamoto, Shelley D.
中科院分区：
文献类型：
--
作者：
Gist, Katja M.;Korst, Armin;Nakano, Stephanie J.;Stauffer, Brian L.;Karimpour-Fard, Anis;Zhou, Wenru;Campbell, Kristen;Wempe, Michael F.;Sucharov, Carmen C.;Miyamoto, Shelley D.
米立酮是一种磷酸二酯酶3型抑制剂，通过增加环磷酸腺苷在心脏中产生正性肌力作用。本研究的目的是评估接受米力农治疗的先天性心脏手术患儿的循环单磷酸环腺苷和米力农浓度。2015年1月至2017年12月的单中心前瞻性观察性试点研究，包括出生至18岁的儿童。在术后第一天的四个时间点测量米立酮和循环环磷酸腺苷浓度，并比较有无低心输出量综合征的患者，根据临床和实验室标准进行定义。纳入50例患者。9例（18%）出现低心输出量综合征。所有患者中，22%患有单心室心脏病。低心输出量综合征患者和无低心输出量综合征患者的单磷酸环腺苷浓度密度和分布存在差异，但无显著性差异。所有患者的米立酮浓度均升高。配对t检验显示无低心输出量综合征患者术后循环单磷酸环腺苷浓度升高。在这项前瞻性观察性研究中，无低心输出量综合征患者术后24小时内循环单磷酸环腺苷浓度升高，所有患者米力酮浓度均升高。进一步研究环磷酸腺苷浓度在米力农治疗患者中的效用是必要的。
Milrinone is a phosphodiesterase type 3 inhibitor that results in a positive inotropic effect in the heart through an increase in cyclic adenosine monophosphate. The purpose of this study was to evaluate circulating cyclic adenosine monophosphate and milrinone concentrations in milrinone treated paediatric patients undergoing congenital heart surgery. Single-centre prospective observational pilot study from January 2015 to December 2017 including children aged birth to 18 years. Milrinone and circulating cyclic adenosine monophosphate concentrations were measured at four time points through the first post-operative day and compared between patients with and without low cardiac output syndrome, defined using clinical and laboratory criteria. Fifty patients were included. Nine (18%) developed low cardiac output syndrome. For all patients, 22% had single ventricle heart disease. The density and distribution of cyclic adenosine monophosphate concentrations varied between those with and without low cardiac output syndrome but were not significantly different. Milrinone concentrations increased in all patients. Paired t-tests demonstrated an increase in circulating cyclic adenosine monophosphate concentrations during the post-operative period among patients without low cardiac output syndrome. In this prospective observational study, circulating cyclic adenosine monophosphate concentrations increased in those without low cardiac output syndrome during the first 24 post-operative hours and milrinone concentrations increased in all patients. Further study of the utility of cyclic adenosine monophosphate concentrations in milrinone treated patients is necessary.