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Enhanced Vasodilatory Responses to Milrinone in Catecholamine-Precontracted Small Pulmonary Arteries

Enhanced Vasodilatory Responses to Milrinone in Catecholamine-Precontracted Small Pulmonary Arteries,10.1213/01.ANE.0000115781.69209.59,Anesthesia and

Enhanced Vasodilatory Responses to Milrinone in Catecholamine-Precontracted Small Pulmonary Arteries   (Citations: 4)
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-Adrenergic agonists (e.g., epinephrine (E) and norepi- nephrine (NE)) and phosphodiesterase-III inhibitors (e.g., milrinone) are often used in combination to augment ven- tricular function in the perioperative period. In the myo- cardium, milrinone acts synergistically with-adrenergic agonists to increase contractility. However, the potential interaction between catecholamines with combined - and-adrenergic activity and milrinone in the pulmonary circulation has not been determined. We evaluated the vasodilatory effects of milrinone and nitroglycerine on large elastic and small muscular porcine pulmonary vas- cular rings precontracted with catecholamines with -adrenergic agonist activity (E and NE), the-adrenergic agonist phenylephrine, and a nonadrenergic agonist, the thromboxane analog U46619. In small pulmonary arter- ies, the vasorelaxation with milrinone was significantly enhanced in rings precontracted with E or NE compared with those precontracted with phenylephrine or U46619. However, in large pulmonary arteries, the vasorelaxation with milrinone was similar in all vessel rings and was not influenced by the agonist used to induce precontraction. In marked contrast, the vasorelaxant responses to nitro- glycerine were not altered by the specific agonist used for precontraction in either small or large pulmonary vascu- lar rings. Thus, the pulmonary vascular effects of milri- none are enhanced when combined with drugs with -adrenoreceptor agonist activity. The vasodilatory inter- actions exhibited by phosphodiesterase-III inhibitors and the catecholamines NE and E suggest that their combined use might be beneficial in circumstances in which ventric- ular dysfunction and increased pulmonary vascular resis- tance occur.
Journal: Anesthesia and Analgesia - ANESTH ANALG , vol. 99, no. 3, pp. 1618-1622, 2004
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