HEMODYNAMIC-EFFECTS OF AMRINONE IN CHILDREN AFTER FONTAN SURGERY

After Fontan repair in children, we performed a prospective, open-labe l study to evaluate the effect of amrinone on pulmonary vascular resis tance (PVRI). Eight patients who underwent the Fontan repair had basel ine arterial pressure, left atrial pressure, central venous pressure, and cardiac output measured postoperatively. Hemodynamic measurements were repeated after amrinone 4.5 mg/kg. The PVRI tended to decrease, b ut the change was not statistically significant. Although the systemic vascular resistance decreased to 802 +/- 222 from 941 +/- 191 dynes . s . cm(-5). m(-2) (P < 0.05), mean arterial blood pressure was unchan ged. Cardiac index (3.8 +/- 1.2 to 4.7 +/- 1.6 L . min(-1). m(-2)) and stroke volume index (23.6 +/- 6.7 to 30.5 +/- 8.1 mL . beat(-1). m(-2 )) increased, and heart rate decreased (160 +/- 21 to 151 +/- 24 bpm) (P < 0.05). Colloid transfusion during amrinone bolus administration w as 13.9 mL/kg. The mean serum amrinone concentration was 4.2 mu g/mL a t the end of bolus and clearance was 2.24 mL . kg(-1). min(-1). Arrhyt hmias and thrombocytopenia were not noted. We conclude that amrinone a dministration is effective in increasing cardiac output in children wh o have undergone a Fontan repair.