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The effect of milrinone on hemodynamic and gas exchange parameters in children

Published online by Cambridge University Press:  17 December 2019

Rohit S. Loomba Open the ORCID record for Rohit S. Loomba [Opens in a new window] ,
Vincent Dorsey ,
Enrique G. Villarreal Open the ORCID record for Enrique G. Villarreal [Opens in a new window]  and
Saul Flores
Rohit S. Loomba
Affiliation:
Cardiology, Pediatrics, Advocate Children’s Heart Institute, Advocate Children’s Hospital, Oak Lawn, IL, USA Medicine, Chicago Medical School/Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
Vincent Dorsey
Affiliation:
Cardiology, Pediatrics, Advocate Children’s Heart Institute, Advocate Children’s Hospital, Oak Lawn, IL, USA
Enrique G. Villarreal*
Affiliation:
Critical Care and Cardiology, Pediatrics, Texas Children’s Hospital/Baylor College of Medicine, Houston, TX, USA Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico
Saul Flores
Affiliation:
Critical Care and Cardiology, Pediatrics, Texas Children’s Hospital/Baylor College of Medicine, Houston, TX, USA
*
Author for correspondence: E. G. Villarreal, MD, Cardiac Intensive Care Unit, Section of Critical Care and Cardiology, Texas Children’s Hospital, Research Scholar Baylor College of Medicine, Houston, TX, USA. Tel: +1 312 282 6935; Fax: +1 832 825 2969; E-mails: quique_villarreal93@hotmail.com; noyola@bcm.edu
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Abstract

Milrinone is a drug frequently used for hemodynamic support in children during critical illness. Although the hemodynamic changes induced by milrinone in children may appear similar to those of adults, the physiologic contributors of these changes remain vastly unknown. A systematic review was conducted to identify studies characterising the hemodynamic effects of milrinone in children during critical illness for hemodynamic support for various medical conditions. Studies were assessed for quality and those of satisfactory quality with pre- and post-operative hemodynamics for each patient were included in the final analyses. Those not limited to children and those not limited to patients with critical illness were excluded from the final analyses. A total of six studies with 791 patients were included in the final analyses. Milrinone infusion doses ranged from 0.3 to 0.75 mcg/kg/minute with the mean infusion dose being 0.5 mcg/kg/minute. Patients whom received milrinone infusion had greater cardiac output, greater left ventricle shortening fraction, lower right ventricular systolic pressure, and lower serum lactate levels. Systolic blood pressure mean arterial blood pressure and arterial oxygen concentration did not significantly change with administration of milrinone. These results were irrespective of milrinone infusion dose, infusion duration, and study size. Milrinone was found to have several beneficial hemodynamic effects in children during critical illness when used at usual clinical doses.

Keywords

Paediatricsmilrinoneintensive care unitsphosphodiesterase 3 inhibitorsheart disease
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 1 , January 2020 , pp. 55 - 61
Copyright
© Cambridge University Press 2019

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