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. 2024 Oct;96(5):1172-1179.
doi: 10.1038/s41390-024-03234-z. Epub 2024 May 14.

Milrinone in persistent pulmonary hypertension of newborn: a scoping review

Radu Galis #  1   2 , Diana Mudura #  3 , Paula Trif  3   4 , Shivashankar Diggikar  5 , Arun Prasath  6 , Maria Livia Ognean  7   8 , Jan Mazela  9 , Adrian Lacatusu  10   11 , Rangasamy Ramanathan  12 , Boris W Kramer  9 , Yogen Singh  13
Affiliations

Milrinone in persistent pulmonary hypertension of newborn: a scoping review

Radu Galis et al. Pediatr Res. 2024 Oct.

Abstract

Persistent pulmonary hypertension of the newborn (PPHN) is a common neonatal condition in newborns admitted to the neonatal intensive care units (NICUs). PPHN has still a high mortality and morbidity. Inhaled nitric oxide (iNO) is the first line vasodilator therapy for PPHN in high income countries. In low-to-middle income countries (LMICs), availability of iNO remains scarce and expensive. The purpose of this scoping review was to evaluate the current existing literature for milrinone therapy in PPHN and to identify the knowledge gaps in milrinone use in infants with PPHN. The available evidence for milrinone remains limited both as monotherapy and as an adjuvant to iNO. The studies were heterogeneous, conducted in different settings, with different populations and more importantly the endpoints of these trials were short-term outcomes such as changes in oxygenation and blood pressure. Large prospective studies investigating long-term outcomes, mortality, and the need for Extracorporeal membrane oxygenation (ECMO) are warranted. Randomized controlled trials with milrinone as monotherapy are needed in LMICs where iNO availability remains limited. IMPACT: Milrinone has a potential role in the management of PPHN both as an adjuvant to iNO as well as a monotherapy. This scoping review identified the problems existing in the published literature on milrinone and the barriers to generalization of these results. Multi-centre randomized controlled trials on milrinone, especially involving centers from low- and middle-income countries are needed, where it can be evaluated as first-line pulmonary vasodilator therapy.

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References

    1. Lakshminrusimha, S. & Keszler, M. Persistent pulmonary hypertension of the newborn. Neoreviews 16, e680–e692 (2015). - DOI - PubMed - PMC
    1. Zhou, R., Zheng, Y.-N., Zhang, X.-Y. & Cheng, Y.-Y. A meta-analysis of the risk factors of persistent pulmonary hypertension in newborns. Front. Pediatr. 9, 659137 (2021). - DOI - PubMed - PMC
    1. Galambos, C. et al. Phenotype characterisation of Tbx4 mutation and deletion carriers with neonatal and paediatric pulmonary hypertension. Eur. Respir. J. 54, 1801965 (2019). - DOI - PubMed
    1. Martinho, S., Adão, R., Leite-Moreira, A. F. & Brás-Silva, C. Persistent pulmonary hypertension of the newborn: pathophysiological mechanisms and novel therapeutic approaches. Front. Pediatr. 8, 342 (2020). - DOI - PubMed - PMC
    1. Davidson, D. et al. Inhaled nitric oxide for the early treatment of persistent pulmonary hypertension of the term newborn: a randomized, double-masked, placebo-controlled, dose-response, multicenter study. The I-NO/PPHN Study Group. Pediatrics 101, 325–334 (1998). - DOI - PubMed

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