Journal article
The effect of milrinone on right and left ventricular function when used as a rescue therapy for term infants with pulmonary hypertension
Cardiology in the young, Vol.26(1), pp.90-99
01/2016
DOI: 10.1017/S1047951114002698
PMID: 25599873
Abstract
Milrinone may be an appropriate adjuvant therapy for infants with persistent pulmonary hypertension of the newborn. We aimed to describe the effect of milrinone administration on right and left ventricular function in infants with persistent pulmonary hypertension not responding to inhaled nitric oxide after 4 hours of administration.
This is a retrospective review of infants born after or at 34 weeks of gestation with persistent pulmonary hypertension who received milrinone treatment. The primary endpoint was the effect of milrinone on myocardial performance and haemodynamics, including right and left ventricular outputs, tissue Doppler velocities, right ventricle and septal strain, and strain rate. Secondary endpoints examined included duration of inhaled nitric oxide and oxygen support.
A total of 17 infants with a mean (standard deviation) gestation and birth weight of 39.8 (2.0) weeks and 3.45 (0.39) kilograms, respectively, were included in the study. The first echocardiogram was performed 15 hours after the commencement of nitric oxide inhalation. Milrinone treatment was started at a median time of 1 hour after the echocardiogram and was associated with an increase in left ventricular output (p=0.04), right ventricular output (p=0.004), right ventricle strain (p=0.01) and strain rate (p=0.002), and left ventricle s` (p<0.001) and a` (p=0.02) waves. There was a reduction in nitric oxide dose and oxygen requirement over the subsequent 72 hours (all p<0.05).
The use of milrinone as an adjunct to nitric oxide is worth further exploration, with preliminary evidence suggesting an improvement in both oxygenation and myocardial performance in this group of infants.
Details
- Title: Subtitle
- The effect of milrinone on right and left ventricular function when used as a rescue therapy for term infants with pulmonary hypertension
- Creators
- Adam T James - 1Department of Paediatrics,The Rotunda Hospital,Dublin,IrelandJohn D Corcoran - 1Department of Paediatrics,The Rotunda Hospital,Dublin,IrelandPatrick J McNamara - 3Department of Physiology and Experimental Medicine,Hospital for Sick Children,Toronto,CanadaOrla Franklin - 5Department of Cardiology,Our Lady's Children's Hospital Crumlin,Dublin,IrelandAfif F El-Khuffash - 1Department of Paediatrics,The Rotunda Hospital,Dublin,Ireland
- Resource Type
- Journal article
- Publication Details
- Cardiology in the young, Vol.26(1), pp.90-99
- DOI
- 10.1017/S1047951114002698
- PMID
- 25599873
- ISSN
- 1047-9511
- eISSN
- 1467-1107
- Language
- English
- Date published
- 01/2016
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology; Internal Medicine
- Record Identifier
- 9984093326902771
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