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Amrinone loading during cardiopulmonary bypass in neonates, infants, and children.

Abstract：

OBJECTIVES:To determine whether amrinone is bound to cardiopulmonary bypass circuits. When amrinone is administered to children during cardiopulmonary bypass, determine whether measured amrinone concentrations differ from those predicted based on a reported volume of distribution of 1.6 L/kg. DESIGN:In vitro study: Uptake of amrinone by cardiopulmonary bypass circuits was determined. Clinical study: Prospective, open label investigation. SETTING:University-affiliated tertiary children's hospital. PARTICIPANTS:Clinical study: 27 children participated, including 5 neonates and 9 infants. INTERVENTIONS:In vitro study: Waste blood was circulated within seven pediatric cardiopulmonary circuits. Amrinone was administered, and blood was serially assayed for amrinone levels. Clinical study: Amrinone (mean dose 4.9 mg/kg) was loaded during cardiopulmonary bypass and amrinone concentrations in pump blood were determined at termination of bypass. Amrinone measured by high-performance liquid chromatography. MEASUREMENTS AND MAIN RESULTS:Cardiopulmonary bypass circuit uptake reduced amrinone concentrations to 79% of predicted. After correcting for circuit uptake, serum amrinone levels in patients were significantly higher than predicted. The levels, expressed in the ratio of measured: predicted amrinone concentration, did not differ among neonates, infants, and children older than 1 year of age. CONCLUSIONS:When amrinone is administered to children during cardiopulmonary bypass, about 20% of the dose becomes bound to the circuit. Available drug is distributed within a smaller volume than predicted. This may be the consequence of the physiologic perturbations of hypothermic cardiopulmonary bypass.

journal_name

J Cardiothorac Vasc Anesth

journal_title

Journal of cardiothoracic and vascular anesthesia

authors

Williams GD,Sorensen GK,Oakes R,Boggs DP,Mulroy JJ Jr,Lynn AM

doi

10.1016/s1053-0770(05)80321-0

subject

Has Abstract

pub_date

1995-06-01 00:00:00

pages

278-82

issue

3

eissn

1053-0770

issn

1532-8422

pii

S1053-0770(05)80321-0

journal_volume

9

pub_type

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