title: The role of milrinone in children with cardiovascular compromise: review of the literature.
abstract: BACKGROUND
  Cardiovascular instability is a common complication in children after cardiac surgery and in various forms of shock.
  
  
  METHODS
  Systematic literature review.
  
  
  RESULTS
  Four randomized controlled trials (RCTs) were included in this systematic literature review. In children after corrective surgery for congenital heart disease milrinone significantly reduced the risk of development of LCOS compared with placebo. In another study in children with high pulmonary vascular resistance and impaired oxygenation after Fontan operation, inhalation of NO with milrinone led to the most significant reduction of pulmonary vascular resistance and improvement of oxygenation. When only milrinone was given these changes were less pronounced. In non-hyperdynamic septic shock, CI, SVI, and DO₂ significantly increased while SVRI significantly decreased after milrinone when compared to placebo.
  
  
  CONCLUSIONS
  There are a limited number of RCTs in children that suggest a beneficial effect of milrinone in the optimization of cardiovascular function after cardiac surgery and in septic shock.
authors.affiliation: Department of Neonatal and Paediatric Intensive Care Medicine, University Hospital of Saarland, Homburg, Germany. sascha.meyer@uniklinik-saarland.de
authors.forename: Sascha
authors.initials: S
authors.lastname: Meyer
authors.forename: Ludwig
authors.initials: L
authors.lastname: Gortner
authors.forename: Kate
authors.initials: K
authors.lastname: Brown
authors.forename: Hashim
authors.initials: H
authors.lastname: Abdul-Khaliq
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D002303:Cardiac Output, Low / Q000188:drug therapy*; D002316:Cardiotonic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D018729:Fontan Procedure; D006330:Heart Defects, Congenital / Q000601:surgery*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D020105:Milrinone / Q000009:adverse effects / Q000627:therapeutic use*; D009569:Nitric Oxide / Q000627:therapeutic use; D010100:Oxygen / Q000097:blood; D011183:Postoperative Complications / Q000188:drug therapy*; D011651:Pulmonary Artery / Q000187:drug effects; D016032:Randomized Controlled Trials as Topic; D012772:Shock, Septic / Q000188:drug therapy; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D002316:Cardiotonic Agents; D009569:Nitric Oxide; D020105:Milrinone; D010100:Oxygen