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Vol. 102, No. 2, 2012
Issue release date: August 2012
Section title: Original Paper
Neonatology 2012;102:130–136
(DOI:10.1159/000339108)

Use of Milrinone to Treat Cardiac Dysfunction in Infants with Pulmonary Hypertension Secondary to Congenital Diaphragmatic Hernia: A Review of Six Patients

Patel N.
Royal Children’s Hospital, Melbourne, Vic., Australia

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 2/7/2012 11:32:49 AM
Accepted: 4/10/2012
Published online: 6/16/2012

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 3

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO

Abstract

Background: Pulmonary hypertension and secondary cardiac dysfunction are important contributors of morbidity and mortality in infants with congenital diaphragmatic hernia (CDH). Milrinone, a phosphodiesterase-3 inhibitor, may be useful in this setting for its combined actions as a pulmonary vasodilator and to improve systolic and diastolic function. Objectives: This study aimed to assess the effects of milrinone on cardiac function and pulmonary artery pressure in infants with CDH. Methods: A retrospective review of echocardiograms performed on infants with CDH who received milrinone was performed. Tissue Doppler imaging velocities were used to assess systolic and diastolic function. Pulmonary artery pressure was assessed from the pattern and velocity of ductal shunting. Results: Six infants with CDH and severe pulmonary hypertension were identified. Systolic and diastolic myocardial velocities were reduced in the right ventricle (RV) and interventricular septum (IVS) at baseline. In the 72 h after commencement of milrinone, there was a significant increase in early diastolic myocardial velocities in the RV, accompanied by increasing systolic velocities in the RV and IVS. Oxygenation index was significantly reduced, blood pressure unchanged, and ductal shunt velocity minimally altered over the same time period. Conclusions: Milrinone use was associated with an improvement in systolic and diastolic function in the RV, corresponding to an improvement in clinical status.


  

Author Contacts

Dr. Neil Patel, BA, MB ChB, MRCPCH, MD
Royal Children’s Hospital
Flemington Road
Melbourne, VIC 3052 (Australia)
Tel. +61 3 9345 5008 or +61 413 417 011, E-Mail neil.patel@rch.org.au

  

Article Information

Received: February 7, 2012
Accepted after revision: April 10, 2012
Published online: June 16, 2012
Number of Print Pages : 7
Number of Figures : 3, Number of Tables : 3, Number of References : 25

  

Publication Details

Neonatology (Fetal and Neonatal Research)

Vol. 102, No. 2, Year 2012 (Cover Date: August 2012)

Journal Editor: Halliday H.L. (Belfast), Speer C.P. (Würzburg)
ISSN: 1661-7800 (Print), eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 2/7/2012 11:32:49 AM
Accepted: 4/10/2012
Published online: 6/16/2012

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 3

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO


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