Effects of phosphodiesterase inhibition on skeletal muscle vasculature

The effect of milrinone on right and left ventricular function when used as a rescue therapy for term infants with pulmonary hypertension

“…The median duration of invasive ventilation for the cohort was 5 [5][6][7][8] days. The median length of hospital stay in the tertiary neonatal intensive care unit was 12 [11][12][13][14][15][16] days. An infant born at 35 5/7 weeks of gestation died before discharge due to polycystic kidney disease, prolonged anhydramnious, and hypoplastic lungs.…”

“…Milrinone is a selective phosphodiesterase 3 inhibitor with pharmacological effects that include relaxation of vascular smooth muscles, enhanced myocardial contractility (inotropy), and improved myocardial relaxation (lusitropy). 10,11 Small case series examining the use of milrinone in this population demonstrate an improvement in clinical parameters and a reduction in the use of nitric oxide. 12,13 In addition, the pharmacokinetic properties of milrinone in the setting of persistent pulmonary hypertension in the newborn have been delineated.…”

Treatment of premature infants with pulmonary hypertension and right ventricular dysfunction with milrinone: a case series

“…Milrinone is a selective PDE3 inhibitor with pharmacological effects, including relaxation of vascular smooth muscle, enhanced myocardial contractility (inotropy) and improved myocardial relaxation (lusitropy). 19,20 In the newborn lamb model, intravenous milrinone augments the action of PGl 2 (prostaglandins) on pulmonary vasculature by significantly shortening the onset and prolonging the duration and degree of pulmonary vasodilation produced by PGI 2 . 21,22 Milrinone may also exhibit synergistic effects with iNO in lowering PVR.…”

Global myocardial function is compromised in infants with pulmonary hypertension

“…This recognition has pertinent therapeutic implications. Milrinone, a selective phosphodiesterase three inhibitor, causes relaxation of vascular smooth muscle, enhances myocardial contractility (inotropy effect) and improves myocardial relaxation (lusitropic effect) (10–12). There are recent pharmacokinetic and clinical neonatal data demonstrating its usefulness in improving oxygenation in term neonates with PPHN when used in conjunction with iNO or in PPHN refractory to iNO therapy (13,14).…”