The implications of Milrinone Lactate in the Postoperative Clinical Management of Surgical Interventions for Congenital Heart Malformations in Children

Abstract

The purpose of the study was to prove to efficacy of Milrinone in the management of open heart surgery in children with congenital heart malformations, the link between Milrinone efficacy and the prevention of low cardiac output syndrome and Milrinone side effects. We conducted a retrospective study on a group of 24 patients, admitted to the Tg Mures Emergency Institute for Cardiovascular Diseases and Transplant, between August 2016 and February 2017. Milrinone was administered to children that underwent open heart surgery for different congenital heart malformations, using doses between 0.25 and 0.75 mcg per kg bodyweight, in continuous intravenous drip, before de-clamping of the Aorta, the procedures being conducted in extracorporeal circulation. We recorded demographic data, biological parameters of renal function, myocardial function and hemodynamic parameters, before and after surgery. The administration of Milrinone determined a reduction of incidence of low cardiac output syndrome, registering only 4 deaths, the survival rate being 83.33%, 13 cases presenting complications. Postoperatively we registered a significant improvement of the mean heart rate. Milrinone proved efficient in the re-establishment of hemodynamic parameters in patients with this type of clinical manifestations. Using Milrinone in children that undergo open heart surgery determines a decrease in incidence of low cardiac output syndrome, its� presence in the pharma market being necessary.