Prague Med. Rep. 2012, 113, 58-65

Heart Failure Treated with Low-dose Milrinone in a Full-term Newborn

S. Šebková1, V. Tomek2, P. Zemanová1, Jan Janota1,3

1Department of Neonatology, Thomayer Hospital, Prague, Czech Republic
2Kardiocentrum and Cardiovascular Research Centre, University Hospital Motol, Prague, Czech Republic
3Institute of Pathological Physiology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic

Received September 23, 2011
Accepted January 16, 2012

A term newborn with a hypocontractile myocardium complicating persistent pulmonary hypertension of the newborn was successfully treated with a low-dose phosphodiesterase III inhibitor milrinone. Echocardiography diagnosed heart failure with a left ventricular ejection fraction of 35% and a left ventricular shortening fraction of 18% and severe persistent pulmonary hypertension of the newborn with oxygenation index of 28. Milrinone was started at an initial dose of 50 mcg/kg, followed by continuous infusion of 0.20 mcg/kg/min. With lowdose milrinone oxygenation index decreased to 3 within 6 hours, left ventricular ejection fraction and left ventricular shortening fraction increased to 57%, and 30%, respectively. Low doses of milrinone might be promising in the treatment of heart failure and persistent pulmonary hypertension of the newborn in term newborns.


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