Home Milrinone Therapy for Paediatric Advanced Heart Failure Patients: A Canadian Single-Centre Experience

CJC Pediatric and Congenital Heart Disease Pub Date : 2025-02-01 DOI:10.1016/j.cjcpc.2024.10.005

Ahmed A. Hassan MBBCh , Aamir Jeewa MBBCh , Lujayn Mahmoud BSc , Harni Ganesarasa BSc , Dawn Nicolson BSc , Sunghoon Minn BSc , Emilie Jean-St-Michel MDCM, MSc , Kristen George CNP

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引用次数: 0

Abstract

Background

End-stage heart failure (ESHF) is the primary reason for heart transplantation in children with cardiomyopathy. Despite optimizing oral heart failure (HF) medications, some paediatric patients progress to ESHF, necessitating mechanical circulatory support and/or transplantation. Continuous milrinone intravenous support has been used to bridge paediatric patients to transplant. This study aimed to review and report the safety and outcomes of our home milrinone therapy (HMT) programme.

Methods

This single-centre, retrospective cohort study included paediatric patients discharged on HMT between 2001 and 2022. Data were collected from the SickKids HF Database. Outcomes of interest included frequency and indications for rehospitalization, catheter-related complications, and outcomes at the conclusion of therapy.

Results

Thirty-six patients were included, with a median age of 3.6 years and a median weight of 13.1 kg at HMT initiation. HMT was used as a bridge to transplantation (58%) recovery/candidacy (22%), palliative care (17%), and surgical repair (3%). The median duration on HMT was 88 days. Twenty-four patients (67%) were readmitted at least once with a total of 70 admissions, primarily due to central line-related issues (35%) and worsening HF (32%). Among patients discharged as a bridge to transplant, 52% were admitted from home for transplant, whereas 33% required readmission until transplant. No deaths were directly related to HMT.

Conclusions

HMT is a safe and effective method for supporting children with ESHF. This therapy allows children to return to their home environment.

查看原文本刊更多论文

儿童晚期心力衰竭患者的家庭米力农治疗：加拿大单中心经验

背景：终末期心力衰竭（ESHF）是心肌病患儿进行心脏移植的主要原因。尽管优化了口服心力衰竭（HF）药物，但一些儿科患者进展为ESHF，需要机械循环支持和/或移植。持续的米力农静脉支持已被用于儿科患者移植的桥梁。本研究旨在回顾和报告我们的家庭米林酮治疗（HMT）方案的安全性和结果。方法本研究为单中心、回顾性队列研究，纳入2001年至2022年间接受HMT治疗出院的儿科患者。数据收集自SickKids HF数据库。结果包括再住院的频率和指征、导管相关并发症和治疗结束时的结果。结果纳入36例患者，HMT开始时的中位年龄为3.6岁，中位体重为13.1 kg。HMT被用作移植（58%）、恢复/候选（22%）、姑息治疗（17%）和手术修复（3%）的桥梁。HMT治疗的中位持续时间为88天。24例患者（67%）至少再入院一次，共入院70例，主要是由于中心线相关问题（35%）和心衰恶化（32%）。在作为移植的桥梁出院的患者中，52%的患者从家中接受移植，而33%的患者需要再次入院直到移植。没有死亡与HMT直接相关。结论shmt是一种安全有效的支持ESHF患儿的方法。这种疗法可以让孩子们回到他们的家庭环境中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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CJC Pediatric and Congenital Heart Disease

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