Milrinone Inhaled in Cardiac Surgery

NCT ID: NCT00819377

Last Updated: 2013-10-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

124 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-02-28

Study Completion Date

2012-12-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Pulmonary hypertension is an important morbidity factor in patients having to undergo cardiac surgery with cardiopulmonary bypass (ECC). Milrinone used in inhalation, shows evidence of being a pulmonary vasodilator able to possibly contribute to the reduction of pressure on the pulmonary artery.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

This controlled, randomized, double-blind study will aim at confirming the efficiency as well as the security of Milrinone, used in inhalation, to diminish the degree of pulmonary hypertension before the cardiopulmonary bypass (ECC) circulation. In addition, the pharmacokinetic and echo graphic repercussions of administering the medication will be analysed. At the present time, there is no data on the pharmacokinetics of the medication when it's administered through inhalation. For this reason, we would like to study the serous rate of the medication in the minutes following its administration through inhalation.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Valvular Stenosis Valvular Insufficiency Hypertension, Pulmonary Coronary Artery Disease

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Valvular surgery pulmonary artery pressure

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Normal saline

Normal saline by inhalation over 15 min

Group Type PLACEBO_COMPARATOR

Normal saline

Intervention Type DRUG

5 ml normal saline by inhalation over 15 min

Milrinone

Inhaled milrinone 5 mg(as for the injectable solution)

Group Type ACTIVE_COMPARATOR

Milrinone

Intervention Type DRUG

inhaled milrinone 5 mg (as for the injectable solution)

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Milrinone

inhaled milrinone 5 mg (as for the injectable solution)

Intervention Type DRUG

Normal saline

5 ml normal saline by inhalation over 15 min

Intervention Type DRUG

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Milrinone Cardiac Surgery Milrinone inhaled Inhaled milrinone reduces pulmonary artery pressure Placebo Comparator

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Adult patients scheduled for elective valvular or complex (2 or more valves or
* valve and revascularization) cardiac surgery under CPB with preoperative PHT defined as mean pulmonary artery pressure (MPAP) over 30 mmHg or
* systolic pulmonary artery pressure (SPAP) over 40 mmHg (using preoperative right-sided catheterization or estimated by echocardiography).

Exclusion Criteria

* Cardiac surgery not requiring CPB, contraindication to TEE (esophageal pathology or unstable cervical spine) and emergency surgery.
* Patients will be recruited the day before surgery and randomized using computerized cards by the pharmacy department
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Heart and stoke fondation of Quebec

UNKNOWN

Sponsor Role collaborator

Organon

INDUSTRY

Sponsor Role collaborator

Canadian Anesthesiologists' Society

OTHER

Sponsor Role collaborator

Andre Denault

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Andre Denault

MD FRCPC ABIM-CCM

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Denault André, MD FRCPC

Role: PRINCIPAL_INVESTIGATOR

Montreal Heart Institute

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Montreal Heart Institute

Montreal, Quebec, Canada

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Canada

References

Explore related publications, articles, or registry entries linked to this study.

Baim DS, McDowell AV, Cherniles J, Monrad ES, Parker JA, Edelson J, Braunwald E, Grossman W. Evaluation of a new bipyridine inotropic agent--milrinone--in patients with severe congestive heart failure. N Engl J Med. 1983 Sep 29;309(13):748-56. doi: 10.1056/NEJM198309293091302.

Reference Type BACKGROUND
PMID: 6888453 (View on PubMed)

Denault AY, Lamarche Y, Couture P, Haddad F, Lambert J, Tardif JC, Perrault LP. Inhaled milrinone: a new alternative in cardiac surgery? Semin Cardiothorac Vasc Anesth. 2006 Dec;10(4):346-60. doi: 10.1177/1089253206294400.

Reference Type BACKGROUND
PMID: 17200091 (View on PubMed)

Omae T, Kakihana Y, Mastunaga A, Tsuneyoshi I, Kawasaki K, Kanmura Y, Sakata R. Hemodynamic changes during off-pump coronary artery bypass anastomosis in patients with coexisting mitral regurgitation: improvement with milrinone. Anesth Analg. 2005 Jul;101(1):2-8, table of contents. doi: 10.1213/01.ANE.0000155262.37491.6A.

Reference Type BACKGROUND
PMID: 15976197 (View on PubMed)

Kikura M, Levy JH, Michelsen LG, Shanewise JS, Bailey JM, Sadel SM, Szlam F. The effect of milrinone on hemodynamics and left ventricular function after emergence from cardiopulmonary bypass. Anesth Analg. 1997 Jul;85(1):16-22. doi: 10.1097/00000539-199707000-00004.

Reference Type BACKGROUND
PMID: 9212116 (View on PubMed)

Lobato EB, Florete O Jr, Bingham HL. A single dose of milrinone facilitates separation from cardiopulmonary bypass in patients with pre-existing left ventricular dysfunction. Br J Anaesth. 1998 Nov;81(5):782-4. doi: 10.1093/bja/81.5.782.

Reference Type BACKGROUND
PMID: 10193294 (View on PubMed)

Iwagaki T, Irie J, Ijichi K, Uratsuji Y. [The effects of milrinone on hemodynamics in patients undergoing cardiac surgery]. Masui. 2001 Apr;50(4):360-4. Japanese.

Reference Type BACKGROUND
PMID: 11345746 (View on PubMed)

Shibata T, Suehiro S, Sasaki Y, Hosono M, Nishi S, Kinoshita H. Slow induction of milrinone after coronary artery bypass grafting. Ann Thorac Cardiovasc Surg. 2001 Feb;7(1):23-7.

Reference Type BACKGROUND
PMID: 11343562 (View on PubMed)

Kim JH, Ham BM, Kim YL, Bahk JH, Ryu HG, Jeon YS, Kim KB. Prophylactic milrinone during OPCAB of posterior vessels: implication in angina patients taking beta-blockers. Eur J Cardiothorac Surg. 2003 Nov;24(5):770-6. doi: 10.1016/s1010-7940(03)00393-2.

Reference Type BACKGROUND
PMID: 14583311 (View on PubMed)

Hoffman TM, Wernovsky G, Atz AM, Kulik TJ, Nelson DP, Chang AC, Bailey JM, Akbary A, Kocsis JF, Kaczmarek R, Spray TL, Wessel DL. Efficacy and safety of milrinone in preventing low cardiac output syndrome in infants and children after corrective surgery for congenital heart disease. Circulation. 2003 Feb 25;107(7):996-1002. doi: 10.1161/01.cir.0000051365.81920.28.

Reference Type BACKGROUND
PMID: 12600913 (View on PubMed)

Maslow AD, Regan MM, Schwartz C, Bert A, Singh A. Inotropes improve right heart function in patients undergoing aortic valve replacement for aortic stenosis. Anesth Analg. 2004 Apr;98(4):891-902. doi: 10.1213/01.ANE.0000107940.23783.33.

Reference Type BACKGROUND
PMID: 15041568 (View on PubMed)

Doolan LA, Jones EF, Kalman J, Buxton BF, Tonkin AM. A placebo-controlled trial verifying the efficacy of milrinone in weaning high-risk patients from cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 1997 Feb;11(1):37-41. doi: 10.1016/s1053-0770(97)90250-0.

Reference Type BACKGROUND
PMID: 9058218 (View on PubMed)

Yamada T, Takeda J, Katori N, Tsuzaki K, Ochiai R. Hemodynamic effects of milrinone during weaning from cardiopulmonary bypass: comparison of patients with a low and high prebypass cardiac index. J Cardiothorac Vasc Anesth. 2000 Aug;14(4):367-73. doi: 10.1053/jcan.2000.7920.

Reference Type BACKGROUND
PMID: 10972598 (View on PubMed)

Solina A, Papp D, Ginsberg S, Krause T, Grubb W, Scholz P, Pena LL, Cody R. A comparison of inhaled nitric oxide and milrinone for the treatment of pulmonary hypertension in adult cardiac surgery patients. J Cardiothorac Vasc Anesth. 2000 Feb;14(1):12-7. doi: 10.1016/s1053-0770(00)90048-x.

Reference Type BACKGROUND
PMID: 10698385 (View on PubMed)

Denault AY, Chaput M, Couture P, Hebert Y, Haddad F, Tardif JC. Dynamic right ventricular outflow tract obstruction in cardiac surgery. J Thorac Cardiovasc Surg. 2006 Jul;132(1):43-9. doi: 10.1016/j.jtcvs.2006.03.014.

Reference Type BACKGROUND
PMID: 16798301 (View on PubMed)

Couture P, Denault AY, Pellerin M, Tardif JC. Milrinone enhances systolic, but not diastolic function during coronary artery bypass grafting surgery. Can J Anaesth. 2007 Jul;54(7):509-22. doi: 10.1007/BF03022314.

Reference Type BACKGROUND
PMID: 17602036 (View on PubMed)

Packer M, Carver JR, Rodeheffer RJ, Ivanhoe RJ, DiBianco R, Zeldis SM, Hendrix GH, Bommer WJ, Elkayam U, Kukin ML, et al. Effect of oral milrinone on mortality in severe chronic heart failure. The PROMISE Study Research Group. N Engl J Med. 1991 Nov 21;325(21):1468-75. doi: 10.1056/NEJM199111213252103.

Reference Type BACKGROUND
PMID: 1944425 (View on PubMed)

Cuffe MS, Califf RM, Adams KF Jr, Benza R, Bourge R, Colucci WS, Massie BM, O'Connor CM, Pina I, Quigg R, Silver MA, Gheorghiade M; Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure (OPTIME-CHF) Investigators. Short-term intravenous milrinone for acute exacerbation of chronic heart failure: a randomized controlled trial. JAMA. 2002 Mar 27;287(12):1541-7. doi: 10.1001/jama.287.12.1541.

Reference Type BACKGROUND
PMID: 11911756 (View on PubMed)

Lamarche Y, Malo O, Thorin E, Denault A, Carrier M, Roy J, Perrault LP. Inhaled but not intravenous milrinone prevents pulmonary endothelial dysfunction after cardiopulmonary bypass. J Thorac Cardiovasc Surg. 2005 Jul;130(1):83-92. doi: 10.1016/j.jtcvs.2004.09.011.

Reference Type BACKGROUND
PMID: 15999045 (View on PubMed)

Haraldsson s A, Kieler-Jensen N, Ricksten SE. The additive pulmonary vasodilatory effects of inhaled prostacyclin and inhaled milrinone in postcardiac surgical patients with pulmonary hypertension. Anesth Analg. 2001 Dec;93(6):1439-45, table of contents. doi: 10.1097/00000539-200112000-00018.

Reference Type BACKGROUND
PMID: 11726420 (View on PubMed)

Sablotzki A, Starzmann W, Scheubel R, Grond S, Czeslick EG. Selective pulmonary vasodilation with inhaled aerosolized milrinone in heart transplant candidates. Can J Anaesth. 2005 Dec;52(10):1076-82. doi: 10.1007/BF03021608.

Reference Type BACKGROUND
PMID: 16326679 (View on PubMed)

Bernstein AD, Parsonnet V. Bedside estimation of risk as an aid for decision-making in cardiac surgery. Ann Thorac Surg. 2000 Mar;69(3):823-8. doi: 10.1016/s0003-4975(99)01424-1.

Reference Type BACKGROUND
PMID: 10750767 (View on PubMed)

Lamarche Y, Perrault LP, Maltais S, Tetreault K, Lambert J, Denault AY. Preliminary experience with inhaled milrinone in cardiac surgery. Eur J Cardiothorac Surg. 2007 Jun;31(6):1081-7. doi: 10.1016/j.ejcts.2007.02.019. Epub 2007 Apr 2.

Reference Type BACKGROUND
PMID: 17400468 (View on PubMed)

Robitaille A, Denault AY, Couture P, Belisle S, Fortier A, Guertin MC, Carrier M, Martineau R. Importance of relative pulmonary hypertension in cardiac surgery: the mean systemic-to-pulmonary artery pressure ratio. J Cardiothorac Vasc Anesth. 2006 Jun;20(3):331-9. doi: 10.1053/j.jvca.2005.11.018. Epub 2006 Apr 19.

Reference Type BACKGROUND
PMID: 16750732 (View on PubMed)

Lindsay CA, Barton P, Lawless S, Kitchen L, Zorka A, Garcia J, Kouatli A, Giroir B. Pharmacokinetics and pharmacodynamics of milrinone lactate in pediatric patients with septic shock. J Pediatr. 1998 Feb;132(2):329-34. doi: 10.1016/s0022-3476(98)70454-8.

Reference Type BACKGROUND
PMID: 9506650 (View on PubMed)

Oddie CJ, Jackman GP, Bobik A. Analysis of milrinone in plasma using solid-phase extraction and high-performance liquid chromatography. J Chromatogr. 1986 Jan 10;374(1):209-14. doi: 10.1016/s0378-4347(00)83274-0. No abstract available.

Reference Type BACKGROUND
PMID: 3949932 (View on PubMed)

Hudson RJ, Thomson IR, Jassal R. Effects of cardiopulmonary bypass on sufentanil pharmacokinetics in patients undergoing coronary artery bypass surgery. Anesthesiology. 2004 Oct;101(4):862-71. doi: 10.1097/00000542-200410000-00010.

Reference Type BACKGROUND
PMID: 15448518 (View on PubMed)

Fiset P, Mathers L, Engstrom R, Fitzgerald D, Brand SC, Hsu F, Shafer SL. Pharmacokinetics of computer-controlled alfentanil administration in children undergoing cardiac surgery. Anesthesiology. 1995 Nov;83(5):944-55. doi: 10.1097/00000542-199511000-00006.

Reference Type BACKGROUND
PMID: 7486179 (View on PubMed)

Denault AY, Bussieres JS, Arellano R, Finegan B, Gavra P, Haddad F, Nguyen AQN, Varin F, Fortier A, Levesque S, Shi Y, Elmi-Sarabi M, Tardif JC, Perrault LP, Lambert J. A multicentre randomized-controlled trial of inhaled milrinone in high-risk cardiac surgical patients. Can J Anaesth. 2016 Oct;63(10):1140-1153. doi: 10.1007/s12630-016-0709-8. Epub 2016 Jul 28.

Reference Type DERIVED
PMID: 27470232 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

08-1004

Identifier Type: -

Identifier Source: org_study_id