Application of a PDE III Inhibitor, Olprinone, for Fast Track Pediatric Cardiac Surgery

Background: We examined the effects of olprinone (OLP), a PDE III inhibitor, on the time to extubation and on the hemodynamics in infants and children undergoing fast track cardiac surgery. Methods: Nineteen consecutive children undergoing fast track cardiac surgery were recruited in this study. In the first five children, chlorpromazine (CPZ) was administered conventionally for the purpose of vasodilation during the cardiac surgery (CPZ group). In the latter fourteen children, OLP (50μg·kg^-1) was administered 30 minutes prior to the weaning from cardiopulmonary bypass (CPB) as a substitute of CPZ (OLP group). Hemodynamic parameters were stored as data at the period of pre-CPB, post-CPB, and at the end of the surgery. Plasma concentration of OLP was measured 30 minutes after CPB. Results: In the OLP group, mean time to extubation was 28.2 min, which is shorter than that in CPZ group (250.4 min). Mean arterial pressure at the end of the surgery was higher in OLP group than in CPZ group. Other hemodynamic variables were not different between the two groups. Plasma concentration of OLP was 22.4 ng·ml ^-1, which is within the therapeutic window. Conclusions: The administration of OLP enables us to perform an immediate early extubation and provides stable hemodynamics. OLP would be useful in children undergoing fast track cardiac surgery.