Abstract | BACKGROUND: DESIGN: Case series of neonates with severe PPHN (defined as oxygenation index [OI] >20, failure of iNO therapy, and echocardiographic confirmation of PPHN). SETTING: Tertiary neonatal intensive care unit. SUBJECTS: Full-term (> or =37 weeks) neonates with severe PPHN who received intravenous milrinone. MEASUREMENTS: The primary end point was the effect of intravenous milrinone on OI and hemodynamic stability over a 72-hour study period. Secondary end points examined included duration of iNO and degree of cardiorespiratory support. RESULTS: Nine neonates at a mean gestation of 39.25 +/- 2.76 weeks, birth weight of 3668 +/- 649.1 g, and baseline OI of 28.1 +/- 5.9 received milrinone treatment after a poor initial response to iNO treatment. Intravenous milrinone was commenced at a median age of 21 hours (range, 18-49 hours), and patients were treated for median of 70 hours (range, 23-136). Oxygenation index was significantly reduced after milrinone treatment, particularly in the immediate 24 hours of treatment (8.0 +/- 6.6, P < .001). There was a significant improvement in heart rate (179 +/- 15.2 vs 149.6 +/- 22.4, P < .001) over the same period. Infants who received milrinone did not develop systemic hypotension; in fact, there was a nonsignificant trend toward improved blood pressure. CONCLUSIONS: Intravenous milrinone produces early improvements in oxygenation without compromising systemic blood pressure.
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Authors | Patrick J McNamara, Firdous Laique, Sataporn Muang-In, Hilary E Whyte |
Journal | Journal of critical care
(J Crit Care)
Vol. 21
Issue 2
Pg. 217-22
(Jun 2006)
ISSN: 0883-9441 [Print] United States |
PMID | 16769471
(Publication Type: Journal Article)
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Chemical References |
- Phosphodiesterase Inhibitors
- Vasodilator Agents
- Cyclic AMP
- Cyclic GMP
- Milrinone
- Oxygen
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Topics |
- Cyclic AMP
(physiology)
- Cyclic GMP
(physiology)
- Humans
- Hypertension, Pulmonary
(congenital, drug therapy, physiopathology)
- Infant, Newborn
- Milrinone
(therapeutic use)
- Oxygen
(blood)
- Phosphodiesterase Inhibitors
(therapeutic use)
- Signal Transduction
- Vasodilator Agents
(therapeutic use)
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