Florian Manoeuvrier, Morgan Recher, Marion Grimaud, Sylvain Renolleau, Olivier Brissaud, Stéphane Leteurtre, Mehdi Oualha, Charles de Marcellus, Groupe Francophone de Réanimation et d’Urgence Pédiatriques
Centre-Université de Paris and Necker-Enfants Malades. CHU Amiens-Picardie. Univ.ersity of Lille and CHU Lille. CHU Bordeaux and Pellegrin-Enfants Hospital.
France
European Journal of Pediatrics
Eur J Pediatr 2025; 184:
DOI: 10.1007/s00431-025-06589-5
Abstract
Purpose: To assess the practical use of milrinone in French-speaking pediatric intensive care units.
Methods: A survey on milrinone therapy use, including indication, dosage, monitoring, weaning and side effects was sent to pediatric intensivists using the e-mail registry of the French-speaking Group of Pediatric Intensive Care and Emergency Medicine Network.
Results: We received 117 responses from French speaking centers (response rate of 31.2%). We observed a high and widespread use (113/117; 96.6%) of milrinone for several cardiovascular indications [right heart failure with pulmonary arterial hypertension (102/112; 91.1%), cardiogenic shock (90/112; 80.4%), decompensation of chronic heart failure (74/112; 66.1%), postoperative management of cardiac surgery (59/112; 52.7%)], with however highly heterogeneous practices on dosing, therapeutic adjustment, treatment monitoring, and weaning. More than half (60/117; 51.3%) of respondents used milrinone at least once a week. Respondents stated that approximately 25% had no protocol for either initiation or weaning. No maximum duration of treatment was reported. The loading dose was rarely administered.
Conclusions: There are a lack of a clear guidance and recommendations for the use of milrinone in critically ill children despite its frequent and widespread use. Further prospective studies and research are mandatory to improve and tailor milrinone use in critically ill neonates and children.
Category
Medical Therapy. Efficacy or Lack of Efficacy
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
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