Year : 2017  |  Volume : 20  |  Issue : 3  |  Page : 318--322

Randomized comparative study of intravenous infusion of three different fixed doses of milrinone in pediatric patients with pulmonary hypertension undergoing open heart surgery


Neeraj Kumar Barnwal1, Sanjeeta Rajendra Umbarkar1, Manjula Sudeep Sarkar1, Raylene J Dias2 
1 Department of Cardiac Anesthesiology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
2 Department of Pediatric Anesthesiology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Neeraj Kumar Barnwal
2/7, Stone Building, B. J. Marg, Byculla, Mumbai - 400 011, Maharashtra
India

Background: Pulmonary hypertension secondary to congenital heart disease is a common problem in pediatric patients presenting for open heart surgery. Milrinone has been shown to reduce pulmonary vascular resistance and pulmonary artery pressure in pediatric patients and neonates postcardiac surgery. We aimed to evaluate the postoperative outcome in such patients with three different fixed maintenance doses of milrinone. Methodology: Patients were randomized into three groups. All patients received fixed bolus dose of milrinone 50 μg/kg on pump during rewarming. Following this, patients in low-dose group received infusion of milrinone at the rate of 0.375 μg/kg/min, medium-dose group received 0.5 μg/kg/min, and high-dose group received 0.75 μg/kg/min over 24 h. Heart rate, mean arterial pressure (MAP), mean airway pressure (MaP), oxygenation index (OI), and central venous pressure (CVP) were compared at baseline and 24 h postoperatively. Dose of inotropic requirement, duration of ventilatory support and Intensive Care Unit (ICU) stay were noted. Results: MAP, MaP, OI, and CVP were comparable in all three groups postoperatively. All patients in the low-dose group required low inotropic support while 70% of patients in the high-dose group needed high inotropic support to manage episodes of hypotension (P = 0.000). Duration of ventilatory support and ICU stay in all three groups was comparable (P = 0.412, P = 0.165). Conclusion: Low-dose infusions while having a clinical impact were more beneficial in avoiding adverse events and decreasing inotropic requirement without affecting duration of ventilatory support and duration of ICU stay.


How to cite this article:
Barnwal NK, Umbarkar SR, Sarkar MS, Dias RJ. Randomized comparative study of intravenous infusion of three different fixed doses of milrinone in pediatric patients with pulmonary hypertension undergoing open heart surgery.Ann Card Anaesth 2017;20:318-322


How to cite this URL:
Barnwal NK, Umbarkar SR, Sarkar MS, Dias RJ. Randomized comparative study of intravenous infusion of three different fixed doses of milrinone in pediatric patients with pulmonary hypertension undergoing open heart surgery. Ann Card Anaesth [serial online] 2017 [cited 2019 Nov 14 ];20:318-322
Available from: http://www.annals.in/article.asp?issn=0971-9784;year=2017;volume=20;issue=3;spage=318;epage=322;aulast=Barnwal;type=0