| Efficacy and safety of milrinone in preventing low cardiac output syndrome in infants and children after corrective surgery for congenital heart disease. | |
| | |
MedLine Citation:
|
PMID: 12600913 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Low cardiac output syndrome (LCOS), affecting up to 25% of neonates and young children after cardiac surgery, contributes to postoperative morbidity and mortality. This study evaluated the efficacy and safety of prophylactic milrinone in pediatric patients at high risk for developing LCOS. METHODS AND RESULTS: The study was a double-blind, placebo-controlled trial with 3 parallel groups (low dose, 25- microg/kg bolus over 60 minutes followed by a 0.25- microg/kg per min infusion for 35 hours; high dose, 75- microg/kg bolus followed by a 0.75- microg/kg per min infusion for 35 hours; or placebo). The composite end point of death or the development of LCOS was evaluated at 36 hours and up to 30 days after randomization. Among 238 treated patients, 25.9%, 17.5%, and 11.7% in the placebo, low-dose milrinone, and high-dose milrinone groups, respectively, developed LCOS in the first 36 hours after surgery. High-dose milrinone significantly reduced the risk the development of LCOS compared with placebo, with a relative risk reduction of 55% (P=0.023) in 238 treated patients and 64% (P=0.007) in 227 patients without major protocol violations. There were 2 deaths, both after infusion of study drug. The use of high-dose milrinone reduced the risk of the LCOS through the final visit by 48% (P=0.049). CONCLUSIONS: The use of high-dose milrinone after pediatric congenital heart surgery reduces the risk of LCOS. |
| | |
Authors:
|
Timothy M Hoffman; Gil Wernovsky; Andrew M Atz; Thomas J Kulik; David P Nelson; Anthony C Chang; James M Bailey; Akbar Akbary; John F Kocsis; Raymond Kaczmarek; Thomas L Spray; David L Wessel |
Related Documents
:
|
20425703 - Early atropine is safer than conventional atropine administration in the elderly underg... 20636563 - Cardiopulmonary effects of two constant rate infusions of dexmedetomidine in isoflurane... 19716383 - Protective effect of hesperidin and naringin against 3-nitropropionic acid induced hunt... |
Publication Detail:
|
Type: Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Circulation Volume: 107 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2003 Feb |
Date Detail:
|
Created Date: 2003-02-25 Completed Date: 2003-03-12 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
|
Languages: eng Pagination: 996-1002 Citation Subset: AIM; IM |
Affiliation:
|
Children's Hospital of Philadelphia, Philadelphia, Pa 19104, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Blood Pressure Cardiac Output, Low / prevention & control* Child Child, Preschool Double-Blind Method Endpoint Determination Female Heart Defects, Congenital / drug therapy*, mortality, surgery* Humans Infant Infant, Newborn Lactic Acid / blood Male Milrinone / adverse effects*, therapeutic use* Oxygen / blood Syndrome |
| Chemical | |
Reg. No./Substance:
|
50-21-5/Lactic Acid; 7782-44-7/Oxygen; 78415-72-2/Milrinone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The antioxidant acetylcysteine reduces cardiovascular events in patients with end-stage renal failur...
Next Document: Factor V Leiden protects against blood loss and transfusion after cardiac surgery.