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Perioperative Milrinone Infusion Improves One-Year Survival After the Norwood-Sano Procedure

Authors :
Tatsuo Iwasaki
Shingo Kasahara
Hiroshi Morimatsu
Kazuyoshi Shimizu
Tomoyuki Kanazawa
Shinichi Otsuki
Kenji Baba
Yasuhiro Kotani
Source :
Journal of Cardiothoracic and Vascular Anesthesia. 35:2073-2078
Publication Year :
2021
Publisher :
Elsevier BV, 2021.

Abstract

Objectives The aim of this study was to investigate whether milrinone infusion improved one-year survival in patients who underwent the Norwood-Sano procedure. Design A retrospective observational study. Setting A single-institution university hospital. Participants Children who underwent the Norwood-Sano procedure from January 2008 to December 2014. Interventions Patients were categorized into two groups: group E+D, who received routine epinephrine and dopamine infusion, and group M, who received routine milrinone infusion for intra- and postoperative inotropic support. Measurements and Main Results The primary outcome of this study was one-year survival after the Norwood-Sano procedure. A total of 45 patients were included (group E+D, 22; group M, 23). One-year survival in group M was significantly higher than that in group E+D (95.7% [22/23] v 72.7% [16/22], p = 0.03). A Kaplan-Meier curve also showed that one-year survival in group M was significantly higher than that in group E+D (p = 0.04), from the result of the log-rank test. The number of patients who had any arrhythmias in the intensive care unit (ICU) was significantly lower in group M than in group E+D (21.7% [5/23] v 50% [11/22], p = 0.03). The duration of ICU stay did not have statistical difference between groups (group M 19; interquartile range [IQR], 15-28) v group E+D 19.5 (IQR, 16.3-35.5) days, p = 0.57). Conclusions Perioperative milrinone infusion improved the mortality after the Norwood-Sano procedure. Potential advantages of milrinone compared with epinephrine are fewer arrhythmias and better systemic perfusion, which could decrease lethal cardiac events in the ICU.

Details

ISSN :
10530770
Volume :
35
Database :
OpenAIRE
Journal :
Journal of Cardiothoracic and Vascular Anesthesia
Accession number :
edsair.doi.dedup.....629a982e5aa9030a43e904f3d214cc8d
Full Text :
https://doi.org/10.1053/j.jvca.2021.02.017