Effects of olprinone on hemodynamics and oxygen delivery in pediatric cardiac surgery: Magnitude of effects and comparison to milrinone

Background and objectivesOur study seeks to evaluate the effects of olprinone on hemodynamics and oxygen delivery on weaning from cardiopulmonary bypass (CPB) and to compare the effects of olprinone and milrinone.MethodsWe retrospectively reviewed 50 pediatric patients administered either olprinone or milrinone on weaning from CPB during cardiac surgery. At 0, 15, 30, 60, 90, and 120 minutes (min) after separation from CPB, we collected data on hemodynamics and oxygen delivery. At the same time points, we also recorded the doses of cardiovascular-acting drugs used concomitantly. We analyzed differences among measurement points by one-way ANOVA and differences between two agents groups by two-way ANOVA.ResultsOlprinone increased systolic blood pressure (sBP) at 120 min in biventricular repair (BV) and from 90 min in Fontan-type operation (FO). Olprinone produced significant stepwise tapering of dopamine from 60 min and dobutamine from 90 min in BV. For BV, olprinone significantly increased central venous oxygen saturation from 30 min; oxygen excess factor at 30 and 120 min; and cerebral tissue oxygen index from 30 min, except at 60 min. Except for a significant increase in sBP and significant tapering of DOA dose at 120 min in BV, milrinone had no effect on any parameters in either type of operation. Comparisons of the two agent groups showed no significant difference in any parameters.ConclusionOlprinone stabilizes circulation and improves oxygen delivery during BV pediatric cardiac surgery. While olprinone may have stronger effects than milrinone in BV, the two agents were comparable for FO.