Does Milrinone Prevent Low Cardiac Output Syndrome in the Pediatric Population after Congenital Heart Surgery?
|The university of Auckland |
|Does Milrinone Prevent Low Cardiac Output Syndrome in the Paediatric Population after Congenital Heart surgery? |
|Nursing 730 (A&B) |
| |
|Paediatric Cardiac Nursing |
|Clinical Practice Review, Assessment 1. |
10th September 2010
Lecturer
|Word Count 2740 |
Congenital heart disease (CHD) accounts for a large portion of clinically significant birth defects, and remains the leading cause of infant deaths (M. Torres, Pharm, & Nieves, 2008). Advances in paediatric cardiology, cardiothoracic surgery and intensive care have dramatically improved survival for these children. However, even with this progress there remains to be an expected and reproducible fall in cardiac output, low cardiac output syndrome (LCOS), after cardiac surgery (Bailey et al., 2004; Ravishankar, Tabbutt, & Wernovsky, 2003; M. Torres, et al., 2008).
In the following assignment I will be reviewing the evidence relating to the use of milrinone, a phosphodiesterase inhibitor that is commonly used to increase cardiac output in children after cardiac surgery. I will focus on LCOS in children and the pathophysiology surrounding this. I will also examine the biological action of milrinone and how it has been shown to increase cardiac output in children after
|Does Milrinone Prevent Low Cardiac Output Syndrome in the Paediatric Population after Congenital Heart surgery? |
|Nursing 730 (A&B) |
| |
|Paediatric Cardiac Nursing |
|Clinical Practice Review, Assessment 1. |
10th September 2010
Lecturer
|Word Count 2740 |
Congenital heart disease (CHD) accounts for a large portion of clinically significant birth defects, and remains the leading cause of infant deaths (M. Torres, Pharm, & Nieves, 2008). Advances in paediatric cardiology, cardiothoracic surgery and intensive care have dramatically improved survival for these children. However, even with this progress there remains to be an expected and reproducible fall in cardiac output, low cardiac output syndrome (LCOS), after cardiac surgery (Bailey et al., 2004; Ravishankar, Tabbutt, & Wernovsky, 2003; M. Torres, et al., 2008).
In the following assignment I will be reviewing the evidence relating to the use of milrinone, a phosphodiesterase inhibitor that is commonly used to increase cardiac output in children after cardiac surgery. I will focus on LCOS in children and the pathophysiology surrounding this. I will also examine the biological action of milrinone and how it has been shown to increase cardiac output in children after
References: Costa Auler Jr, J. O., Costa Barreto, A., Gimenez, S. O., & Abellan, D. M. (2002). Pediatric Cardiac Postoperative Care. Rev.Hosp.Clin.Fac.Med.S.Paulo, 57(3), 115-123. Duggal, B., Pratap, U., Slavik, Z., Kaplanova, J., & Macrae, D. (2005). Milrinone and low cardiac output following cardiac surgery in infants: is there a direct myocardial effect? Pediatric Cardiology, 26(5), 642-645. Hazinski, M. F. (1992). Nursing care of the critically ill child (2nd ed.). St. Louis: Mosby-Year Book. Jones, B., Hayden, M., Fraser, J. F., & Janes, E. (2005). Low cardiac output syndrome in children. Current Anaesthesia & Critical Care, 16(6), 347-358. Kulasekaran K, Sargent PH, & Flenady V. (2004). Milrinone for the treatment of cardiac dysfunction in neonates (Protocol) (Publication no. 10.1002/14651858.CD004952.). from John Wiley & Sons, Ltd: McCance, K Ramamoorthy, C., Anderson, G. D., Williams, G. D., & Lynn, A. M. (1998). Pharmacokinetics and side effects of milrinone in infants and children after open heart surgery. Anesthesia & Analgesia, 86(2), 283-289. Ravishankar, C., Tabbutt, S., & Wernovsky, G. (2003). Critical care in cardiovascular medicine. Current opinion in Pediatrics, 15, 443-453. Torres, A. (2010). Therapy. Efficacy and safety of milrinone in preventing low cardiac output syndrome in infants and children after corrective surgery for congenital heart disease. Retrieved 25 August, 2010. Torres, M., Pharm, D., & Nieves, J. A. (2008). Progress in Congenital Cardiac Care for newborns and Infants: The emerging Role of "off-Label" Medications. Newborn and Infand Nursing Reviews, 9(1), 18-30.