Efficacy and Safety of Milrinone in Preventing Low Cardiac Output Syndrome in Infants and Children After Corrective Surgery for Congenital Heart Disease
Timothy M. Hoffman,Gil Wernovsky,Andrew M. Atz,Thomas J. Kulik,David P. Nelson,Anthony C. Chang,James M. Bailey,Akbar Akbary,John F. Kocsis,Raymond Kaczmarek,Thomas L. Spray,David L. Wessel +11 more
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TLDR
The use of high-dose milrinone after pediatric congenital heart surgery reduces the risk of low cardiac output syndrome (LCOS), a contributes to postoperative morbidity and mortality.Abstract:
Background— Low cardiac output syndrome (LCOS), affecting up to 25% of neonates and young children after cardiac surgery, contributes to postoperative morbidity and mortality. This study evaluated the efficacy and safety of prophylactic milrinone in pediatric patients at high risk for developing LCOS. Methods and Results— The study was a double-blind, placebo-controlled trial with 3 parallel groups (low dose, 25-μg/kg bolus over 60 minutes followed by a 0.25-μg/kg per min infusion for 35 hours; high dose, 75-μg/kg bolus followed by a 0.75-μg/kg per min infusion for 35 hours; or placebo). The composite end point of death or the development of LCOS was evaluated at 36 hours and up to 30 days after randomization. Among 238 treated patients, 25.9%, 17.5%, and 11.7% in the placebo, low-dose milrinone, and high-dose milrinone groups, respectively, developed LCOS in the first 36 hours after surgery. High-dose milrinone significantly reduced the risk the development of LCOS compared with placebo, with a relative ...read more
Citations
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Part 14: Pediatric Advanced Life Support 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Monica E. Kleinman,Leon Chameides,Stephen M. Schexnayder,Ricardo A. Samson,Mary Fran Hazinski,Dianne L. Atkins,Marc D. Berg,Allan R. de Caen,Ericka L. Fink,Eugene B. Freid,Robert W. Hickey,Bradley S. Marino,Vinay M. Nadkarni,Lester T. Proctor,Faiqa Qureshi,Kennith Sartorelli,Alexis A. Topjian,Elise W. van der Jagt,Arno Zaritsky +18 more
TL;DR: In contrast to adults, cardiac arrest in infants and children does not usually result from a primary cardiac cause, more often it is the terminal result of progressive respiratory failure or shock, also called an asphyxial arrest.
Journal ArticleDOI
European Resuscitation Council Guidelines for Resuscitation 2015
Gavin D. Perkins,Gavin D. Perkins,Anthony J. Handley,Rudolph W. Koster,Maaret Castrén,Michael Smyth,Theresa M. Olasveengen,Koenraad G. Monsieurs,Koenraad G. Monsieurs,Violetta Raffay,Jan-Thorsten Gräsner,Volker Wenzel,Giuseppe Ristagno,Jasmeet Soar,Leo Bossaert,Antonio Caballero,Pascal Cassan,Cristina Granja,Claudio Sandroni,David Zideman,Jerry P. Nolan,Ian Maconochie,Robert Greif +22 more
TL;DR: This chapter contains guidance on the techniques used during the initial resuscitation of an adult cardiac arrest victim and the use of an automated external defibrillator (AED).
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Vasoactive-inotropic score as a predictor of morbidity and mortality in infants after cardiopulmonary bypass
Michael Gaies,James G. Gurney,Alberta H. Yen,Michelle L. Napoli,Robert J. Gajarski,Richard G. Ohye,John R. Charpie,Jennifer C. Hirsch +7 more
TL;DR: The usefulness of vasoactive–inotropic score as an independent predictor of clinical outcome in infants after cardiac surgery may have important implications for future cardiothoracic intensive care unit research.
Journal ArticleDOI
Pediatric Basic Life Support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Marc D. Berg,Stephen M. Schexnayder,Leon Chameides,Mark Terry,Aaron Donoghue,Robert W. Hickey,Robert A. Berg,Robert M. Sutton,Mary Fran Hazinski +8 more
TL;DR: For best survival and quality of life, pediatric basic life support should be part of a community effort that includes prevention, early cardiopulmonary resuscitation (CPR), prompt access to the emergency response system, and rapid pediatric advanced life support (PALS), followed by integrated post–cardiac arrest care.
Journal ArticleDOI
Hypoplastic Left Heart Syndrome : Current Considerations and Expectations
Jeffrey A. Feinstein,D. Woodrow Benson,Anne M. Dubin,Meryl S. Cohen,Dawn M. Maxey,William T. Mahle,Elfriede Pahl,Juan Villafane,Ami B. Bhatt,Lynn F. Peng,Beth Ann Johnson,Alison L. Marsden,Curt J. Daniels,Nancy Rudd,Christopher A. Caldarone,Kathleen A. Mussatto,David L.S. Morales,D. Dunbar Ivy,J. William Gaynor,James S. Tweddell,Barbara J. Deal,Anke K. Furck,Geoffrey L. Rosenthal,Richard G. Ohye,Nancy S. Ghanayem,John P. Cheatham,Wayne Tworetzky,Gerard R. Martin +27 more
TL;DR: The current state of the art in the understanding and treatment of HLHS during the stages of care is presented, including perioperative care, interstage monitoring, and management strategies, and issues surrounding the genetics, developmental outcomes, and quality of life are addressed.
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Milrinone: Systemic and pulmonary hemodynamic effects in neonates after cardiac surgery
TL;DR: Administration of milrinone in neonates with low cardiac output after cardiac surgery lowers filling pressures, systemic and pulmonary arterial pressures, and systemic andmonary vascular resistances, while improving cardiac index.
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John R. Charpie,Mary K. Dekeon,Caren S. Goldberg,Ralph S. Mosca,Edward L. Bove,Thomas J. Kulik +5 more
TL;DR: Serial blood lactate level measurements may be an accurate predictor of death or the requirement for extracorporeal membrane oxygenator support for patients who undergo complex neonatal cardiac surgery.