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A Population Pharmacokinetic Analysis of Milrinone in Pediatric Patients After Cardiac Surgery

  • James M. BaileyEmail author
  • Timothy M. Hoffman
  • David L. Wessel
  • David P. Nelson
  • Andrew M. Atz
  • Anthony C. Chang
  • Thomas J. Kulik
  • Thomas L. Spray
  • Akbar Akbary
  • Richard P. Miller
  • Gil Wernovsky
Article

Abstract

The purpose of this study was to ascertain the optimal pharmacokinetic model for milrinone in pediatric patients after cardiac surgery when milrinone was administered as a slow loading dose followed by a constant-rate infusion. The data used for pharmacokinetic analysis were collected in a prospective, randomized, placebo-controlled multi-center trial of milrinone as prophylaxis for the development of low cardiac output syndrome after surgery for repair of complex congenital cardiac defects. Two blood samples were randomly collected from each patient for determination of plasma milrinone concentrations with subsequent population pharmacokinetic modeling. The pharmacokinetics of milrinone in pediatric patients under 6year's age were best described by a weight-normalized one compartment model after a slow loading dose followed by a constant-rate infusion. The volume of distribution was 482mlkg−1, and was independent of age. Clearance was a linear function of age given by Cl=2.42mlkg−1min−1[1+0.0396*age].

congenital heart disease phosphodiesterase inhibitors milrinone pharmacokinetics mixed-effects modeling 

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Copyright information

© Plenum Publishing Corporation 2004

Authors and Affiliations

  • James M. Bailey
    • 1
    • 2
    Email author
  • Timothy M. Hoffman
    • 3
  • David L. Wessel
    • 4
  • David P. Nelson
    • 5
  • Andrew M. Atz
    • 6
  • Anthony C. Chang
    • 7
  • Thomas J. Kulik
    • 8
  • Thomas L. Spray
    • 9
  • Akbar Akbary
    • 10
  • Richard P. Miller
    • 10
  • Gil Wernovsky
    • 11
  1. 1.Emory University School of MedicineAtlanta
  2. 2.Department of Anesthesiology, Northeast Georgia Medical CenterAnesthesia Associates of GainesvilleGainesville
  3. 3.Columbus Children's HospitalColumbus
  4. 4.Boston Children's HospitalBoston
  5. 5.Cincinnati
  6. 6.Medical University of South CarolinaCharleston
  7. 7.Texas Children's HospitalHouston
  8. 8.University of Michigan HospitalAnn Arbor
  9. 9.The Children's Hospital of PhiladelphiaPhiladelphia
  10. 10.Sanofi-Synthelabo Inc.NewYork
  11. 11.The Children's Hospital of PhiladelphiaPhiladelphia

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