Journal article
Neonatal persistent pulmonary hypertension treated with milrinone: four case reports
Biology of the neonate, Vol.89(1), pp.1-5
2006
DOI: 10.1159/000088192
PMID: 16155380
Abstract
Current standard therapy for persistent pulmonary hypertension of the newborn (PPHN) consists of optimal lung inflation, hemodynamic support and selective vasodilation with inhaled nitric oxide (iNO). However, not all infants will respond. Milrinone, a phosphodiesterase (PDE) III inhibitor, is routinely used in pediatric cardiac intensive care units to improve inotropy and reduce afterload. Although its use in post-operative cardiac failure has been proven in a randomized trial, it has not been reported to be beneficial in PPHN. We report four cases with severe PPHN treated with a combination of iNO and Milrinone. All four cases were unresponsive to therapy including iNO, with a mean oxygenation index (OI) of 40 (standard deviation (SD) 12)) before Milrinone. Substantial improvement in OI (mean of 28; SD 16) was followed by extubation and survival. However, of 4 patients, 2 developed serious intraventricular hemorrhages (IVHs), and 1 had a small IVH. To clarify the risk benefit ratio, of death versus survival with impairment, a randomized controlled trial is needed.
Details
- Title: Subtitle
- Neonatal persistent pulmonary hypertension treated with milrinone: four case reports
- Creators
- Dirk Bassler - Division of Neonatology, Department of Paediatrics, McMaster University Medical Centre, Hamilton, Ont., CanadaKaren ChoongPatrick McNamaraHaresh Kirpalani
- Resource Type
- Journal article
- Publication Details
- Biology of the neonate, Vol.89(1), pp.1-5
- DOI
- 10.1159/000088192
- PMID
- 16155380
- ISSN
- 0006-3126
- eISSN
- 1421-9727
- Language
- English
- Date published
- 2006
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology; Internal Medicine
- Record Identifier
- 9984093599002771
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