Document Detail


Relation of milrinone after surgery for congenital heart disease to significant postoperative tachyarrhythmias.
MedLine Citation:
PMID:  21890079     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Milrinone reduces the risk of low cardiac output syndrome for some pediatric patients after congenital heart surgery. Data from adults undergoing cardiac surgery suggest an association between milrinone and an increased risk of postoperative arrhythmias. We tested the hypothesis that milrinone is an independent risk factor for tachyarrhythmias after congenital heart surgery. Subjects undergoing congenital heart surgery at our institution were consecutively enrolled for 38 months, through September 2010. The data were prospectively collected, including a review of full-disclosure telemetry and the medical records. Within 38 months, 603 enrolled subjects underwent 724 operative procedures. The median age was 5.5 months (range 0.0 to 426), the median weight was 6.0 kg (range 0.7 to 108), and the cohort was 45% female. The overall arrhythmia incidence was 50%, most commonly monomorphic ventricular tachycardia (n = 85, 12%), junctional ectopic tachycardia (n = 69, 10%), accelerated junctional rhythm (n = 58, 8%), and atrial tachyarrhythmias (including atrial fibrillation, atrial flutter, and ectopic or chaotic atrial tachycardia, n = 58, 8%). Multivariate logistic regression analysis demonstrated that independent of age <1 month, the use of cardiopulmonary bypass, the duration of cardiopulmonary bypass, Risk Adjusted classification for Congenital Heart Surgery, version 1, score >3, and the use of epinephrine or dopamine, milrinone use on admission to the cardiac intensive care unit remained independently associated with an increase in the odds of postoperative tachyarrhythmia resulting in an intervention (odds ratio 2.8, 95% confidence interval 1.3 to 6.0, p = 0.007). In conclusion, milrinone use is an independent risk factor for clinically significant tachyarrhythmias in the early postoperative period after congenital heart surgery.
Authors:
Andrew H Smith; Jill Owen; Kristie Y Borgman; Frank A Fish; Prince J Kannankeril
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-09-03
Journal Detail:
Title:  The American journal of cardiology     Volume:  108     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-14     Completed Date:  2012-01-03     Revised Date:  2014-03-14    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1620-4     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Arrhythmias, Cardiac / drug therapy*,  epidemiology,  etiology
Cardiac Surgical Procedures / adverse effects*
Child
Child, Preschool
Dose-Response Relationship, Drug
Female
Heart Defects, Congenital / surgery*
Heart Rate / drug effects*
Humans
Incidence
Infant
Infant, Newborn
Male
Milrinone / administration & dosage,  therapeutic use*
Phosphodiesterase 3 Inhibitors / administration & dosage,  therapeutic use
Postoperative Care / methods*
Retrospective Studies
Risk Factors
Tennessee / epidemiology
Treatment Outcome
Young Adult
Grant Support
ID/Acronym/Agency:
1 UL1 RR024975/RR/NCRR NIH HHS; 5T32HD 44328/HD/NICHD NIH HHS; HL076265/HL/NHLBI NIH HHS; KL2 RR024977/RR/NCRR NIH HHS; KL2 TR000446/TR/NCATS NIH HHS; TL1 RR024978/RR/NCRR NIH HHS; TL1 TR000447/TR/NCATS NIH HHS; UL1 RR024975/RR/NCRR NIH HHS; UL1 RR024975-01/RR/NCRR NIH HHS; UL1 TR000445/TR/NCATS NIH HHS
Chemical
Reg. No./Substance:
0/Phosphodiesterase 3 Inhibitors; JU9YAX04C7/Milrinone
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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