Administration of Milrinone Following Tetralogy of Fallot Repair Increases Postoperative Volume Administration Without Improving Cardiac Output
Main finding · Postoperative volume administrationResult — go to the resultDifference 14% 95% CI 1%–27%Authors' conclusion
The use of milrinone within the first 72 hours following TOF repair is associated with more frequent administration of volume, a positive association between a higher total dose of postoperative milrinone and the amount of postoperative volume administered, a higher heart rate, and a lower blood pressure, but is not associated with improved cardiac output.
Study context
- Population
- Patients undergoing primary surgical repair of tetralogy of Fallot (TOF) with pulmonary stenosis or atresia, Boston Children's Hospital, 2011–2020212 matched
- Participants
- 351 patients
- Exposure
- Milrinone vs no milrinone after TOF repair
- Milrinonen = 106
- Nonmilrinonen = 106reference
- Outcome
- Need for postoperative volume administration
- Follow-up
- First 72 hours postoperatively
Methodological detailspropensity-score matched (1:1), single-centre
- Propensity-score matched (1:1)
- Single-centre
Main finding
Postoperative volume administration
Difference
14%
95% CI 1%–27%
P = 0.036
By group
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Difference (BPM) (95% CI) | |
|---|---|---|
| Heart rate difference at peak · 12 hours postoperatively | 8 (5–12) | |
| −5051015Difference, BPM (linear scale) |
| Outcome | Difference in slope (beats per minute [BPM]/h) (95% CI) | P value |
|---|---|---|
| Recovery of tachycardia (HR slope) · first 12 hoursSlower recovery with milrinone | 0.30 (0.14–0.47) | P < 0.001 |
Cardiac output, incl. arteriovenous oxyhemoglobin saturation difference
- Milrinone not associated with improved cardiac output
Total volume vs cumulative postoperative milrinone dose (Milrinone, matched) · first 72 postoperative hours
- Correlation r
- 0.20
- Additional volume per 1000 µg/kg milrinone, mL/kg
- 11.0 (95% CI 0.6-21.4)
- R 95% CI 0.01-0.38; P = .036
Original publication
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