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Matern Health Neonatol Perinatol. 2018 Dec 3;4:24. doi: 10.1186/s40748-018-0093-1. eCollection 2018.

The use of milrinone in neonates with persistent pulmonary hypertension of the newborn - a randomised controlled trial pilot study (MINT 1): study protocol and review of literature.

Author information

1
1Department of Neonatology, The Rotunda Hospital, Dublin, Ireland.
2
2Department of Paediatrics, Royal College of Surgeons, Dublin, Ireland.
3
Division of Neonatology, Stead Family Department of Pediatrics, Iowa City, IA USA.
4
4Department of Clinical Research, The Rotunda Hospital, Dublin, Ireland.
5
5Department of Neonatology, Radboud University Medical Center, Nijmegen, The Netherlands.
6
6Department of Pharmacy, The Rotunda Hospital, Dublin, Ireland.
7
7School of Pharmacy, Royal College of Surgeons, Dublin, Ireland.
8
8Department of Paediatric Cardiology, Our Lady's Children's Hospital Crumlin, Dublin, Ireland.
9
9INFANT Centre, University College Cork, Cork, Ireland.
10
10Department of Paediatrics and Child Health, University College Cork, Cork, Ireland.

Abstract

Persistent pulmonary hypertension of the newborn (PPHN) is a relatively common condition which results in a mortality of up to 33%. Up to 40% of infants treated with nitric oxide (iNO) either have a transient response or fail to demonstrate an improvement in oxygenation. Milrinone, a selective phosphodiesterase 3 (PDE3) inhibitor with inotropic and lusitropic properties may have potential benefit in PPHN. This pilot study was developed to assess the impact of milrinone administration on time spent on iNO in infants with PPHN. This is a multicentre, randomized, double-blind, two arm pilot study, with a balanced (1:1) allocation of 20 infants. In this pilot study, we hypothesise that infants ≥34 weeks gestation and ≥ 2000 g with a clinical and echocardiography diagnosis of PPHN, intravenous milrinone used in conjunction with iNO will result in a reduction in the time spent on iNO. In addition, we hypothesise that milrinone treatment will lead to an improvement in myocardial performance and global hemodynamics when compared to iNO alone. We will also compare the rate of adverse events associated with the milrinone, and the pre-discharge outcomes of both groups. The purpose of this pilot study is to assess the feasibility of performing the trial and to obtain preliminary data to calculate a sample size for a definitive multi-centre trial of milrinone therapy in PPHN. Trial registration: www.isrctn.com; ISRCTN:12949496; EudraCT Number:2014-002988-16.

KEYWORDS:

Milrinone; Neonates; Nitric oxide; Phosphodiesterase; Pulmonary hypertension

Conflict of interest statement

This study received ethical approval from the Clinical Research Ethics Committee, University College Cork, Ireland [Ref: ECM 5 (4) 03/03/15 & ECM 3 (bbbb) 09/05/17]. This study obtained Health Product Regulatory Authority Approval [CT Number: CT 900/557/1, Case Number 2190463].Not applicable.The authors declare that they have no completing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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