||inotropic agent (phosphodiesterase inhibitor)
- increases contractility and cardiac index
- lowers capillary wedge pressure
- lowers pulmonary artery pressures
- increases the rate of myocardial relaxation (lusitropic effect)
- Loading Dose:
- 50 mcg/kg IV over 10 minutes
- Administer loading dose from the infusion bag; programme the infusion pump to deliver the bolus dose over 10 minutes
- Maintenance Infusion:
- 0.375-0.75 mcg/kg/min, adjusted to cardiac index, venous oxygen saturation or other marker of cardiac output
- dose reduction required in renal dysfunction (e.g. infusion rate starting at 0.2 mcg/kg/min)
50 mg in 250 ml NS or D5W
- hypovolemia, acidosis and hypoxemia should be corrected concurrently with therapy
- arrhythmias (supraventricular and ventricular)
- headache, angina/chest pain
- thrombocytopenia (0.5% vs amrinone 2.4%)
- use with caution in patients with uncontrolled atrial fibrillation/flutter as will enhance AV node conduction; consider digitalizing these patients first
- HR, ECG
- urine output
- cardiac index
- arterial lactate
- platelet count
- May be administered by IV infusion by an approved nurse in CCTC.
- Must be administered via a central line.
- Continuous infusion must be administered via an infusion pump.
- May be titrated by an approved nurse in CCTC.
- Should not be administered via the proximal injectate port (blue) of the Swan Ganz catheter.
- Patient requires placement of an arterial line to monitor BP.