The therapeutic effects of milrinone in treatment of enterovirus 71-induced pulmonary oedema
Abstract number: 902_p1236
To evaluate the potential therapeutic effect of milrinone, a phosphodieasterase (PDE) inhibitor, in treatment of patients with enterovirus 71 (EV71)-induced pulmonary oedema.
Twenty-four children with severe EV71-induced pulmonary oedema were enrolled, from April 1998 through June 2003, in southern Taiwan. They were divided into groups treated before and after the introduction of milrinone therapy. Aetiological diagnosis was made by viral cultures and identified by specific immunofluorescence and neutralisation tests.
All 24 patients were below 5 years of age. The mortality was lower in milrinone-treated than in milrinone-untreated group (36.4 vs. 92.3%, P = 0.005). Sympathetic tachycardia was decreased in patients treated with milrinone compared with controls (205.7 ± 25.8 vs. 143.5 ± 17.1/min, P = 0.004). A marked decrease in IL-13 (76.6 ± 8.8 vs. 162.1 ± 87.5 pg/mL, P = 0.001) was observed in milrinone-treated patients compared with controls. There was a significant reduction in WBC (10 800 ± 500 vs. 19 500 ± 800/cmm, P = 0.009) and platelet counts (256 600 ± 44 700 vs. 400 100 ± 86 500/cmm, P = 0.001) in milrinone-treated patients compared with controls.
The administration of milrinone was associated with a lower mortality in patients with EV71-induced pulmonary oedema and cardiopulmonary failure. The results appear to be related to improvement in sympathetic regulation and decrease in IL-13 production. Milrinone therapy may provide a valuable therapeutic approach for this highly lethal disorder."
|Session name:||XXIst ISTH Congress|
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