{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T18:37:58Z","timestamp":1774723078720,"version":"3.50.1"},"reference-count":21,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2022,10,3]],"date-time":"2022-10-03T00:00:00Z","timestamp":1664755200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951122003171_as1\"><jats:title>Background:<\/jats:title><jats:p>There is a paucity of information reported regarding the use of milrinone in patients with hypoplastic left heart syndrome prior to the Norwood procedure. At our institution, milrinone is initiated in the pre-operative setting when over-circulation and elevated serum lactate levels develop. We aimed to review the responses associated with the administration of milrinone in the pre-operative hypoplastic left heart syndrome patient. Second, we compared patients who received high- versus low-dose milrinone prior to Norwood procedure.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951122003171_as2\"><jats:title>Methods:<\/jats:title><jats:p>Single-centre retrospective study of patients diagnosed with hypoplastic left heart syndrome between January 2000 and December 2019 who underwent Norwood procedure. Patient characteristics and outcomes were compared.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951122003171_as3\"><jats:title>Results:<\/jats:title><jats:p>During the study period, 375 patients were identified; 79 (21%) received milrinone prior to the Norwood procedure with median lactate 2.55 mmol\/l, and SpO2 93%. Patients who received milrinone were older at the time of Norwood procedure (6 vs. 5 days) and were more likely to be intubated and sedated. In a subset analysis stratifying patients to low- versus high-dose milrinone, median lactate decreased from time of initiation (2.39 vs 2.75 to 1.6 vs 1.8 mmol\/l) at 12 hours post-initiation, respectively. Repeated measures analysis showed a significant decrease in lactate levels by 4 hours following initiation of milrinone, that persisted over time, with no significant difference in mean arterial pressure.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951122003171_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>The use of milrinone in the pre-operative over-circulated hypoplastic left heart syndrome patient is well tolerated, is associated with decreased lactate levels, and was not associated with significant hypotension or worsening of excess pulmonary blood flow.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951122003171","type":"journal-article","created":{"date-parts":[[2022,10,3]],"date-time":"2022-10-03T10:07:29Z","timestamp":1664791649000},"page":"1691-1699","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":5,"title":["Milrinone for treatment of elevated lactate in the pre-operative newborn with hypoplastic left heart syndrome"],"prefix":"10.1017","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2893-6882","authenticated-orcid":false,"given":"Asaad G.","family":"Beshish","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaa","family":"Aljiffry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Aronoff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhaval","family":"Chauhan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tawanda","family":"Zinyandu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohua","family":"Basu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subhadra","family":"Shashidharan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin O.","family":"Maher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2022,10,3]]},"reference":[{"key":"S1047951122003171_ref10","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.9.1269"},{"key":"S1047951122003171_ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s40262-013-0096-z"},{"key":"S1047951122003171_ref21","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951119002865"},{"key":"S1047951122003171_ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198301063080106"},{"key":"S1047951122003171_ref12","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000000388"},{"key":"S1047951122003171_ref13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-0803.2011.00584.x"},{"key":"S1047951122003171_ref14","first-page":"CD009515","article-title":"Prophylactic milrinone for the prevention of low cardiac output syndrome and mortality in children undergoing surgery for congenital heart disease","volume":"25","author":"Burkhardt","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"S1047951122003171_ref18","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000051365.81920.28"},{"key":"S1047951122003171_ref5","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000002478"},{"key":"S1047951122003171_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)62741-5"},{"key":"S1047951122003171_ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-007-9022-1"},{"key":"S1047951122003171_ref17","first-page":"e5693","article-title":"Acute effects of hypoxic gas admixtures on pulmonary blood flow and regional oxygenation in children awaiting Norwood palliation","volume":"11","author":"Thomas","year":"2019","journal-title":"Cureus"},{"key":"S1047951122003171_ref2","doi-asserted-by":"publisher","DOI":"10.2147\/PHMT.S98327"},{"key":"S1047951122003171_ref20","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.003554"},{"key":"S1047951122003171_ref15","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2021.02.017"},{"key":"S1047951122003171_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3468(93)90670-G"},{"key":"S1047951122003171_ref19","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000198626.67391.34"},{"key":"S1047951122003171_ref11","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951107001187"},{"key":"S1047951122003171_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(86)90459-X"},{"key":"S1047951122003171_ref3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.022816"},{"key":"S1047951122003171_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(97)00313-5"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951122003171","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T07:11:16Z","timestamp":1695625876000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951122003171\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,3]]},"references-count":21,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["S1047951122003171"],"URL":"https:\/\/doi.org\/10.1017\/s1047951122003171","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,3]]},"assertion":[{"value":"\u00a9 The Author(s), 2022. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}