A case of sepsis-induced cardiomyopathy successfully rescued with improvement in hemodynamics without adverse effects by continuing the administration of a low dose of milrinone during continuous hemofiltration dialysis therapy

Abstract

Milrinone, excreted primarily through the kidneys, should be carefully administered in patients with renal dysfunction because of the risk of adverse effects caused by prolonged half-life and increased blood concentration due to delayed metabolism and excretion. Milrinone, with its high plasma protein binding rate, cannot be efficiently eliminated even by blood purification therapy, and the most appropriate method of milrinone administration during such therapy remains unknown. In the present study, we report a case of sepsis induced cardiomyopathy caused by peritonitis, for which life-saving treatment was successfully performed without adverse effects by carefully continuing the administration of a low dose of milrinone during blood purification therapy and discontinuing its administration early after the improvement of hemodynamics. If administering milrinone during blood purification therapy, it should be carefully continued at a low dose for a limited period of time under monitored conditions to promptly identify adverse effects, such as fatal arrhythmia and hypotension.