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首页> 外文期刊>The Canadian journal of hospital pharmacy. >Use of Milrinone in Critically III Children
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Use of Milrinone in Critically III Children

机译：在严重危重症儿童中使用米力农

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Background: Optimal dose adjustment of milrinone in critically ill children is challenging because of conflicting information about the association between dose and outcomes in this age group. Objectives: To describe the use of milrinone in critically ill children and to explore associations between milrinone dosing and clinical outcomes, specifically effectiveness and adverse events. Methods: This retrospective cohort study was performed in a consecutive sample of children admitted to a university-affiliated critical care unit (January to June 2004). The relations between milrinone dosing and its effectiveness (based on prevention of low cardiac output syndrome, defined as a difference in oxygen saturation between arterial and mixed venous blood of at least 30% or an increase in serum lactate > 2 mmol/L) and its adverse effects (thrombocytopenia, arrhythmia) were evaluated by logistic regression. Results: A total of 197 children from 213 admissions (ranging in age from newborn to 18 years) were included in the study. Milrinone was initiated with a median loading dose of 99.2 ug/kg (range 22.1-162.2 mug/kg). The initial loading dose was higher if given in the operating room rather than the Critical Care Unit (median 99.7 versus 51.0 mug/kg; p < 0.001). Subsequent loading doses, for patients who received them, were lower (median 49 mug/kg). Milrinone was infused at a median rate of 0.64 mug/kg per minute (range 0.13-2.08 mug/kg per minute) for a median of 43.1 h. There was no relation between serum creatinine level and the maintenance dose of milrinone (r~2 <= 0.0335). Low cardiac output syndrome was relatively frequent (166 [77.9%] of the 213 admissions). There was a trend for occurrence of this syndrome in patients with greater average milrinone dose rate (odds ratio [OR] 8.21, 95% confidence interval [CI] 0.98-69.15,p = 0.053) and with longer duration of milrinone therapy (OR 1.01, 95% CI 1.01-1.02, p< 0.05). Adverse events were relatively frequent (thrombocyto...
机译：背景：由于该年龄组中剂量与预后之间的关联性信息存在冲突，因此对危重儿童中米力农的最佳剂量调整具有挑战性。目的：描述米力农在危重儿童中的使用，并探讨米力农剂量与临床结果之间的关联，特别是有效性和不良事件。方法：这项回顾性队列研究是对连续入选大学附属重症监护室（2004年1月至2004年6月）的儿童进行的。米力农剂量与药效之间的关系（基于预防低心输出量综合征，定义为动脉和混合静脉血之间的氧饱和度差异至少30％或血清乳酸> 2 mmol / L增加）不良反应（血小板减少，心律不齐）通过逻辑回归进行评估。结果：研究共纳入213名儿童（从新生儿到18岁）的197名儿童。开始使用米力农酮的中位负荷剂量为99.2 ug / kg（范围22.1-162.2杯/ kg）。如果在手术室而不是重症监护室使用，则初始负荷剂量会更高（中位数99.7对51.0杯/千克; p <0.001）。对于接受这些治疗的患者，随后的加药剂量要低一些（中位数49马克杯/千克）。米力农以0.64马克杯/千克/分钟（0.13-2.08马克杯/千克/分钟）的中位速率输注43.1小时。血清肌酐水平与米力农维持剂量之间没有关系（r〜2 <= 0.0335）。低心输出量综合征相对频繁（213例入院者中的166例[77.9％]）。米力农平均剂量率较高（赔率[OR] 8.21，95％置信区间[CI] 0.98-69.15，p = 0.053）且米力农治疗时间更长（OR 1.01）的患者有发生这种综合征的趋势。 ，95％CI 1.01-1.02，p <0.05）。不良事件相对频繁（血小板...

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