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

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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.

Original languageEnglish
Pages (from-to)2073-2078
Number of pages6
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume35
Issue number7
DOIs
Publication statusPublished - Jul 2021

Keywords

  • HLHS
  • Norwood
  • epinephrine
  • milrinone
  • mortality
  • one-year survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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