Journal article
Hemodynamic response to milrinone for refractory hypoxemia during therapeutic hypothermia for neonatal hypoxic ischemic encephalopathy
Journal of perinatology, Vol.41(9), pp.2345-2354
09/01/2021
DOI: 10.1038/s41372-021-01049-y
PMID: 33850285
Abstract
Objective Characterize the impact of milrinone on arterial pressure of neonates with persistent hypoxemic respiratory failure (HRF) and hypoxic ischemic encephalopathy (HIE) treated with inhaled nitric oxide and therapeutic hypothermia (TH). Study design Retrospective cohort study. Arterial pressure was assessed hourly for 24 h. The primary outcome was change in diastolic arterial pressure (DAP). Results 56 patients were included [(i) cases: HIE/TH who received milrinone (n = 9), (ii) Milrinone controls (n = 17), (iii) HIE controls (n = 30)]. Baseline demographics, severity of HRF and arterial pressure were comparable between groups. Only milrinone treated patients with HIE/TH had a marked drop in DAP in the first hour, which persisted for more than 12 h despite escalation in inotropes (p = 0.008). Conclusion Milrinone treated patients with HRF and HIE/TH develop profound reduction in DAP and require escalation of cardiovascular support. The risk benefit profile of milrinone should be considered and pharmacological studies are warranted to evaluate drug metabolism and clearance in this population.
Details
- Title: Subtitle
- Hemodynamic response to milrinone for refractory hypoxemia during therapeutic hypothermia for neonatal hypoxic ischemic encephalopathy
- Creators
- Adrianne R. Bischoff - University of TorontoSharifa Habib - University of TorontoPatrick J. McNamara - University of IowaRegan E. Giesinger - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of perinatology, Vol.41(9), pp.2345-2354
- Publisher
- Springer Nature
- DOI
- 10.1038/s41372-021-01049-y
- PMID
- 33850285
- ISSN
- 0743-8346
- eISSN
- 1476-5543
- Number of pages
- 10
- Language
- English
- Date published
- 09/01/2021
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology; Internal Medicine
- Record Identifier
- 9984354036102771
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