A population pharmacokinetic analysis of milrinone in pediatric patients after cardiac surgery

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 prospecti...

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Bibliographic Details
Published in:Journal of pharmacokinetics and pharmacodynamics 2004-02, Vol.31 (1), p.43-59
Main Authors: BAILEY, James M, HOFFMAN, Timothy M, WERNOVSKY, Gil, WESSEL, David L, NELSON, David P, ATZ, Andrew M, CHANG, Anthony C, KULIK, Thomas J, SPRAY, Thomas L, AKBARY, Akbar, MILLER, Richard P
Format: Article
Language:English
Subjects:
Age Factors
Biological and medical sciences
Cardiac Surgical Procedures
Cardiotonic Agents - administration & dosage
Cardiotonic Agents - blood
Cardiotonic Agents - pharmacokinetics
Child, Preschool
Dose-Response Relationship, Drug
Double-Blind Method
Drug therapy
Humans
Infant
Infant, Newborn
Linear Models
Medical sciences
Milrinone - administration & dosage
Milrinone - blood
Milrinone - pharmacokinetics
Models, Biological
Pharmacology. Drug treatments
Postoperative Period
Prospective Studies
Randomized Controlled Trials as Topic
Time Factors
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Summary: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 6 year'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 482 ml kg(-1) and was independent of age. Clearance was a linear function of age given by Cl = 2.42 ml kg(-1) min(-1) [1 + 0.396*age].
ISSN:1567-567X
1573-8744
DOI:10.1023/B:JOPA.0000029488.45177.48