Milrinone use for hemodynamic instability in patent ductus arteriosus ligation

J Matern Fetal Neonatal Med. 2017 Mar;30(5):529-533. doi: 10.1080/14767058.2016.1177720. Epub 2016 May 5.

Abstract

Objective: Determine if prophylactic milrinone improves cardiovascular or long-term clinical outcomes in preterm neonates who receive surgical patent ductus arteriosus (PDA) ligation.

Study design: Retrospective review of 45 infants over a 4-year period that received a PDA ligation at one institution. Data were collected on morbidity and mortality outcomes for all infants as well as milrinone therapy perioperatively.

Results: Of the 45 infants that were studied 15 received milrinone in the perioperative period of PDA ligation and the remaining 30 infants did not receive milrinone. The use of milrinone showed no statistically significant improvement in acute markers of hemodynamic stability. There was also no statistically significant difference in morbidity and mortality outcomes in milrinone group compared to the non-milrinone group.

Conclusion: Prophylactic milrinone use for premature infants following PDA ligation does not show a significant cardiovascular or long-term clinical benefit.

Keywords: Milrinone; patent ductus arteriosus; post-ligation cardiac syndrome; preterm; prophylactic.

MeSH terms

  • Birth Weight
  • Chi-Square Distribution
  • Ductus Arteriosus, Patent / surgery*
  • Gestational Age
  • Hemodynamics / drug effects*
  • Humans
  • Infant, Extremely Premature
  • Infant, Newborn
  • Infant, Premature, Diseases
  • Ligation
  • Milrinone / therapeutic use*
  • Retrospective Studies
  • Statistics, Nonparametric
  • Vasodilator Agents / therapeutic use*

Substances

  • Vasodilator Agents
  • Milrinone