Home Milrinone in Pediatric Hospice Care of Children with Heart Failure

Hollander, Seth A.; Wujcik, K.; Schmidt, Julie A.; Liu, Esther; Lin, Aileen; Dykes, J.C.; Good, Julie; Brown, Michelle; Rosenthal, David N.

doi:10.1016/j.jpainsymman.2022.11.014

Cited by 1 publication

(1 citation statement)

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“…In the treatment of children with congenital heart disease complicated by acute heart failure, the advantage of milrinone is that it can significantly improve the cardiac function of children [ 36 ]. Compared with children with simple heart failure, the treatment of congenital heart disease with acute heart failure is more difficult [ 37 ]. When treated with digoxin, this drug mainly relieves the symptoms of congenital heart disease complicated by acute heart failure by positive inotropic action and negative frequency effect, because the myocardial cells and myocardial contractility are damaged obviously [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Milrinone for the treatment of heart failure caused by severe Pneumonia in children with congenital heart disease: a meta-analysis

Shao,

Diao,

Zhou

et al. 2023

BMC Pediatr

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Background Children with congenital heart disease (CHD) are easily complicated by severe pneumonia and heart failure. We aimed to conduct a meta-analysis to evaluate the effects and safety of milrinone for the treatment of heart failure caused by severe pneumonia in children with CHD to provide evidence for the clinical CHD treatment. Methods Two authors searched MEDLINE, PubMed, Embase, Science Direct, Cochrane Central Register of Controlled Trials, the Cochrane Library, Wanfang database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure (CNKI) for randomized controlled trials (RCTs) about the application of milrinone in the treatment of heart failure caused by severe pneumonia in children with CHD in children up to December 10, 2022. Two evaluators independently selected the literature, extracted data and evaluated the methodological quality, meta-analysis was carried out with RevMan 5.3 software. Results Eight RCTs involving 680 CHD children complicated by severe pneumonia and heart failure were included in this meta-analysis. Meta-analysis indicated that total effective rate of the milrinone group was higher than that of control group (RR = 1.25, 95%CI: 1.17 ~ 1.34, P < 0.001), the time to stable heart rate of the milrinone group was less than that of control group (RR=-0.88, 95%CI: -1.09~ -0.67, P < 0.001). The time to stable respiration of the milrinone group was less than that of control group (RR=-0.98, 95%CI: -1.17~ -0.78, P < 0.001). The LVEF of the milrinone group was higher than that of control group (RR = 6.46, 95%CI: 5.30 ~ 7.62, P < 0.001). There was no significant difference in the incidence of adverse reactions between the milrinone group and control group (RR = 0.85, 95%CI: 0.47 ~ 1.56, P = 0.061). Funnel plots and Egger regression test results indicated that there were no statistical publication bias amongst the synthesized outcomes (all P > 0.05). Conclusions Milrinone is beneficial to improve clinical symptoms and cardiac function and increase the therapeutic effect and safety in children with CHD complicated by severe pneumonia and heart failure. However, more RCTs with large samples and rigorous design are needed to verify this finding.

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Section: Discussionmentioning

confidence: 99%