Platelet and Tissue cAMP: Novel Biomarkers of Milrinone Efficacy in Children

Launched by UNIVERSITY OF COLORADO, DENVER · Mar 30, 2016

Keywords

ClinConnect Summary

Milrinone is a phosphodiesterase type III (PDE3) inhibitor with sites of action in cardiac and vascular smooth muscle. PDE3 hydrolyzes the critical second messenger cyclic adenosine monophosphate (cAMP), and PDE3 inhibition (PDE3i) results in a positive inotropic effect in the heart through an increase in cAMP. PDE3i causes relaxation of the vascular smooth muscle and induces vasodilation while concomitantly reducing myocardial oxygen consumption.

In adults, long term PDE3i results in malignant arrhythmias and an increased risk of sudden death, and is therefore not a recommended therapy in...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Children aged birth to 18 year of age
• • Surgical complexity STAT score \> 3
• • Use of cardiopulmonary bypass for cardiac surgery
• • Use of milrinone intra-operatively and post-operatively
• Exclusion Criteria:
• • Patients on milrinone therapy prior to surgery
• • Gestational age less than 34 weeks at the time of surgery
• • Weight less than 2500 grams at the time of surgery
• • Abnormal renal function prior to cardiac surgery. Abnormal renal function is defined as a serum creatinine \> 0.3mg/dL above baseline (lowest value in the preceding 3 months prior to surgery) compared to the level obtained immediately prior to cardiac surgery.