Effects of prostaglandin E_1 and milrinone on pulmonary hypertension in children during intracardiac surgery

Objective To evaluate the effects of prostaglandin E1(PGE1) and milrinone on pulmonary hypertension(PH) in children with congenital heart disease(CHD) during intracardiac surgery.Methods Thirty CHD children with PH were randomly divided into two groups with 15 cases each.Group A was given PGE1 20 ng·kg-1·min-1 via catheter placed in pulmonary artery until the end of operation.In group B,additional milrinone was administered at a bolus of 50 μg/kg via internal jugular vein in 10 min,which was followed by a continueous infusion at a rate of 0.5 μg·kg-1·min-1.MAP,PASP,CI,PVR and SVR were measured before(T0),at skin incise(T1),before CPB(T2),at the time of heart rebeating(T3),at the end of CPB(T4) and at the end of surgery(T5).Results MAP,CI,SVR of group A were lower at T3 than that at T0.MAP,CI of group B were higher and SVR was lower at T2,T4-5 than those at T0.Compared with group A,PASP,PVR of group B were decreased and MAP,CI were increased at T2-T5(P0.05).Conclusion Continuous infusion of PGE1 combined with milrinone can effectively reduce PASP and PVR and protect myocardial function in CHD children with PH undergoing open heart surgery.