Milrinone: Friend or Foe?

Session slides (PPT) (PDF)

PCICS Podcast 109: Milrinone: Trash or Treasure?

Pressure volume loop refresher

Important papers

PRIMACORP Study – Efficacy and safety of milrinone in preventing low cardiac output syndrome in infants and children after corrective surgery for congenital heart disease.

JACC, 2022 – Importance of stressed volume in heart failure

Wave Intensity Analysis – Milrinone Acts as a Vasodilator But Not an Inotrope in Children After Cardiac Surgery – Critical Care Medicine 2020

Milrinone Improves Mortality after Norwood

Identification of Vasodilating Effect of Milrinone on Limbs in Heart Failure Patients – differences based on intra-arterial vs systemic infusions

Milrinone Administration and Pediatric Cardiac Surgery- Beloved but Sadly Misunderstood

2024 Cochrane Review

 

Clinical studies

Milrinone use following TOF increases need for volume adminstration without increasing CO

Postoperative protocol that includes Milrinone improves outcomes following stage 1 palliation

First experiences with milrinone in humans

Animal studies and physiology papers

Milrinone does not increase contractility in an isolated heart preparation with constant loading conditions (and a video explaining Langendorff preparations)

Venous return and mean systemic filling pressure: physiology and clinical applications

Separation of the direct myocardial and vasodilator actions of milrinone administered by an intracoronary infusion technique

Milrinone relaxes pulmonary veins in guinea pigs and humans

Aortic impedance and vasodilator therapy in HF patients

First description of milrinone in dogs

Milrinone effect on capacitance vessels

Milrinone decreases CVP in hepatectomy patients

Population pharmacokinetics of milrinone

Review papers and editorials

Editorial – Milrinone following congenital heart surgery – sadly misunderstood

Review paper of phosphodiesterase inhibitors

Hemodynamics review paper

PDE inhibitors in heart failure review