Previously, an oral version was in use in the outpatient setting for symptomatic treatment of New York Heart Association (NYHA) class III/IV CHF however, this fell out of favor due to increased patient mortality secondary to ventricular arrhythmia and sudden cardiac death. Ĭlinicians direct the use of milrinone in the outpatient setting to patients with severe symptoms of congestive heart failure (CHF) refractory to optimal medical therapy. Milrinone is used chiefly in the ICU and the cardiac unit for cardiac support in patients with acute heart failure, weaning patients with pre-existing left ventricular dysfunction from cardiopulmonary bypass, or as a temporizing agent for patients with plans to undergo cardiac surgery or transplantation. Likewise, it has utility in non-cardiac surgeries for patients with acute decompensated left ventricular heart failure, acute right ventricular heart failure, or pulmonary artery hypertension. Milrinone is often used during cardiac surgeries, including coronary artery bypass graft surgery, cardiac transplantation, and other cardiac surgeries requiring cardiac support. Milrinone is approved for short short-term IV therapy for patients with acute decompensated heart failure with reduced ejection fraction in need of inotropic support. Its use is primarily in the perioperative and ICU settings, although it also has utility for outpatient therapy in special patient populations. It has the overall effect of increased cardiac output, improved left ventricle-arterial coupling, and enhanced cardiac mechanical efficiency. It improves cardiac contractility (inotropy) and cardiac relaxation (lusitropy) and induces vasodilation. Milrinone is a medication indicated for cardiac support in patients with acute heart failure, pulmonary hypertension, or chronic heart failure. It will also discuss its role throughout various specialties of medicine, including ICU care, perioperative care, use in pediatric populations, and the now discontinued use in the outpatient setting as an oral medication. This activity will review its mechanism of action, indications, and potential harm and benefits associated with its use. Its use is primarily in the perioperative and ICU settings, although it also has utility for outpatient therapy in select patient populations. It functions by improving cardiac contractility (inotropy), cardiac relaxation (lusitropy), and inducing vasodilation and has the overall effect of increased cardiac output, improvement of left ventricle-arterial coupling, and enhanced cardiac mechanical efficiency. It is often used during cardiac surgeries, including coronary artery bypass graft surgery, cardiac transplantation, and other cardiac surgeries requiring cardiac support.
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