Study on the hemodynamics effect of milrinone on treating severe congenital heart disease (CHD) of children with pulmonary hypertension

Objective To study the clinical curative effect of using milrinone on treating children severe congenital heart disease (CHD) complicated with pulmonary hypertension (PH),and the effect on hemodynamics.Methods Forty-five severe CHD children with PH were divided into group A and group B randomly.Group A (25 patients) were administrated by venous injection of milrinone with a dose of 0.5 ug / (kg·min) for 5 days;group B (20 patients) were administrated by venous injection of dopamine with a dose of 5ug/ (kg·min) for 5 days.Observe the clinical effect and the change of some hemodynamics in group using milrinone,such as pulmonary artery blood flow related to systemic blood flow (Qp/Qs),left cardiac index of ventricle (LV-CI),cardiac index of right ventricle (RV-CI),pulmonary arterial systolic pressure (PASP),heart rate (HR) and systolic blood pressure (SBP),and compare with the group using dopamine.Results After using milrinone for 5 days,the clinical manifestation and physical sign of patients in group A had remarkable improvement (P0.05),and the PASP and Qp/Qs were significantly lower while LV-CI was higher (P0.05),and the heart rate and blood pressure had unremarkable change (P0.05).The total effect rate of milrinone reached 92.0%,and the total effect rate in group B only reached 75.0%; the improvement of hemodynamics was not obvious (P0.05).The difference of clinical effect and the hemodynamics after the therapy between group A and B was of statistical significance (P0.05).Conclusion Milrinone has positive inotropic and vasodilator activity,which has the function of selective dilation of pulmonary vascular bed,can improve the cardiorespiratory function and reduce pulmonary artery pressure obviously in children severe congenital heart disease (CHD) with pulmonary hypertension (PH);however,it dose not change the heart rate and blood pressure.