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Cited by 57Congenital Heart Disease StudiesHemodynamic Monitoring and TherapyCardiac and Coronary Surgery Techniques

The DOI matches its Crossref record; 21 of the 21 references it cites were found in a registry or an index.

Prevention of low cardiac output syndrome after pediatric cardiac surgery: a double-blind randomized clinical pilot study comparing dobutamine and milrinone

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Cavigelli-Brunner, Anna, Hug, Maja I., Dave, Hitendu, Baenziger, Oskar, Buerki, Christoph, Bettex, Dominique, Cannizzaro, Vincenzo, Balmer, Christian·2018·Pediatric Critical Care Medicine
DOI 10.1097/pcc.0000000000001533
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Abstract

OBJECTIVES: Dobutamine and milrinone are commonly used after open-heart surgery to prevent or treat low cardiac output syndrome. We sought to compare efficacy and safety of these drugs in pediatric patients. DESIGN: Prospective, single-center, double-blinded, randomized clinical pilot study. SETTING: Tertiary-care university children's hospital postoperative pediatric cardiac ICU. PATIENTS: After written consent, 50 consecutive patients (age, 0.2-14.2 yr; median, 1.2 yr) undergoing open-heart surgery for congenital malformations were included. INTERVENTIONS: After cardiopulmonary bypass, a continuous infusion of either dobutamine or milrinone was administered for the first 36 postoperative hours. Maximum dose: dobutamine 6 µg/kg/min, milrinone 0.75 µg/kg/min. MEASUREMENTS AND MAIN RESULTS: There were no significant differences in demographic data, complexity of surgery, and intraoperative characteristics between the two study groups (dobutamine vs milrinone). Efficacy was defined as need for additional vasoactive support, which did not differ between groups (dobutamine 61% vs milrinone 67%; p = 0.71). Sodium nitroprusside was used more often in the dobutamine group (42% vs 13%; p = 0.019). Systolic blood pressure showed a trend toward higher values in the dobutamine group, whereas both drugs increased heart rate early postoperatively. Echocardiography demonstrated a consistently good cardiac function in both groups. Central venous oxygen saturation, serum lactate levels, urine output, time to chest tube removal, length of mechanical ventilation, ICU, and hospital stay were similar in both groups. Both drugs were well tolerated, no serious adverse events occurred. CONCLUSIONS: Dobutamine and milrinone are safe, well tolerated, and equally effective in prevention of low cardiac output syndrome after pediatric cardiac surgery. The hemodynamic response of the two drugs is comparable. In uncomplicated cases, a trend toward the more cost-saving dobutamine might be anticipated; however, milrinone demonstrated a trend toward higher efficacy in afterload reduction.

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Crossref · 10.1097/pcc.0000000000001533

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Metadata

Authors
Cavigelli-Brunner, A., Hug, M. I., Dave, H., Baenziger, O., Buerki, C., Bettex, D., Cannizzaro, V., & Balmer, C.
Affiliations
  • University of Zurich (CH)
  • Children’s Research Centre, University Children’s Hospital Zurich, Zurich, Switzerland
  • Department of Anaesthesiology, University Hospital Zurich, Zurich, Switzerland.
ORCID
Venue
Pediatric Critical Care Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2018-07
Volume
19
Issue
7
Pages
619-625
ISSN
1529-7535 (ISSN-L)
DOI
10.1097/pcc.0000000000001533
OpenAlex
W2789676766
Cited by
57
References
21
Citations by year
2026: 11 · 2025: 8 · 2024: 4 · 2023: 13 · 2022: 4 · 2021: 8 · 2020: 4 · 2019: 4 · 2018: 1
FWCI
3.32
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • Pediatric Critical Care Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
  • Zurich Open Repository and Archive (University of Zurich)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
  • Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
  • Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
Keywords
low cardiac output syndrome, dobutamine, milrinone, pediatric cardiac surgery, congenital heart disease, cardiopulmonary bypass, sodium nitroprusside, afterload reduction, hemodynamic response, drug safety and tolerability
MeSH terms
Adolescent, Cardiac Output, Low, Cardiopulmonary Bypass, Cardiotonic Agents, Child, Child, Preschool, Dobutamine, Double-Blind Method, Female, Heart Defects, Congenital, Humans, Infant, Male, Pilot Projects, Postoperative Period, Prospective Studies, Intensive Care Units, Pediatric, Milrinone

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