Comparison of early and late intravenous infusion of milrinone in children upto 1 year undergoing cardiac surgery.

Objective:  To compare the effects of early and late use of milrinone in children upto 1  year undergoing complex cardiac surgery. Study design:- prospective randomized study. Methods: A prospective study involved 30 children undergoing congenital corrective cardiac surgery,classified randomly into two groups. Group A: Milrinone infusion  was started without loading dose at  0.5mcg/kg/min at the beginning of CPB and continued postoperatively (0.5-0.75 mcg/kg/min) in the paediatric cardiac surgical ICU . Group B: Milrinone was started as a loading dose of 50mcg/kg over 10 min after aortic declamping and continued as infusion  postoperatively at 0.5-0.75 mcg/kg/min  in the pediatric cardiac surgical ICU.Data were collected at baseline, 1st ,6th  and  12th   postoperative hours in the ICU. Results: The inotropic supports and mechanical supports were needed more in group B than group A. The comparison of heart rate, CVP were insignificant between the two groups (P>0.05). The mean arterial blood pressure through the first 6 hours postoperatively was higher in group A than group B (P<0.05), but became insignificant through other timepoints. The urine output and central venous oxygen saturation were higher in group A than group B (P<0.05).The serum lactate levels were significantly higher in group B more than group A (P<0.05). Conclusion:Early use of milrinone, lead to easy weaning from Cardiopulmonary bypass, decreased requirement of pharmacological and mechanical support and decreased incidence of low cardiac output syndrome after pediatric cardiac surgery and there was no complications related to milrinone in our study patients.