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Meta-Analysis
. 2015 Mar 25;2015(3):CD009515.
doi: 10.1002/14651858.CD009515.pub2.

Prophylactic milrinone for the prevention of low cardiac output syndrome and mortality in children undergoing surgery for congenital heart disease

Barbara E U Burkhardt  1 , Gerta Rücker, Brigitte Stiller
Affiliations
Meta-Analysis

Prophylactic milrinone for the prevention of low cardiac output syndrome and mortality in children undergoing surgery for congenital heart disease

Barbara E U Burkhardt et al. Cochrane Database Syst Rev. .

Abstract

Background: Children with congenital heart disease often undergo heart surgery at a young age. They are at risk for postoperative low cardiac output syndrome (LCOS) or death. Milrinone may be used to provide inotropic and vasodilatory support during the immediate postoperative period.

Objectives: This review examines the effectiveness of prophylactic postoperative use of milrinone to prevent LCOS or death in children having undergone surgery for congenital heart disease.

Search methods: Electronic and manual literature searches were performed to identify randomised controlled trials. We searched CENTRAL, MEDLINE, EMBASE and Web of Science in February 2014 and conducted a top-up search in September 2014 as well as clinical trial registries and reference lists of published studies. We did not apply any language restrictions.

Selection criteria: Only randomised controlled trials were selected for analysis. We considered studies with newborn infants, infants, toddlers, and children up to 12 years of age.

Data collection and analysis: Two review authors independently extracted data according to a pre-defined protocol. We obtained additional information from all study authors.

Main results: Three of the five included studies compared milrinone versus levosimendan, one study compared milrinone with placebo, and one compared milrinone verus dobutamine, with 101, 242, and 50 participants, respectively. Three trials were at low risk of bias while two were at higher risk of bias. The number and definitions of outcomes were non-uniform as well. In one study comparing two doses of milrinone and placebo, there was some evidence in an overall comparison of milrinone versus placebo that milrinone lowered risk for LCOS (risk ratio (RR) 0.52, 95% confidence interval (CI) 0.28 to 0.96; 227 participants). The results from two small studies do not provide enough information to determine whether milrinone increases the risk of LCOS when compared to levosimendan (RR 1.22, 95% CI 0.32 to 4.65; 59 participants). Mortality rates in the studies were low, and there was insufficient evidence to draw conclusions on the effect of milrinone compared to placebo or levosimendan or dobutamine regarding mortality, the duration of intensive care stay, hospital stay, mechanical ventilation, or maximum inotrope score (where available). Numbers of patients requiring mechanical cardiac support were also low and did not allow a comparison between studies, and none of the participants of any study received a heart transplantation up to the end of the respective follow-up period. Time to death within three months was not reported in any of the included studies. A number of adverse events was examined, but differences between the treatment groups could not be proven for hypotension, intraventricular haemorrhage, hypokalaemia, bronchospasm, elevated serum levels of liver enzymes, or a reduced left ventricular ejection fraction < 50% or reduced left ventricular fraction of shortening < 28%. Our analysis did not prove an increased risk of arrhythmias in patients treated prophylactically with milrinone compared with placebo (RR 3.59, 95% CI 0.83 to 15.42; 238 participants), a decreased risk of pleural effusions (RR 1.78, 95% CI 0.92 to 3.42; 231 participants), or a difference in risk of thrombocytopenia on milrinone compared with placebo (RR 0.86, 95% CI 0.39 to 1.88; 238 participants). Comparisons of milrinone with levosimendan or with dobutamine, respectively, did not clarify the risk of arrhythmia and were not possible for pleural effusions or thrombocytopenia.

Authors' conclusions: There is insufficient evidence of the effectiveness of prophylactic milrinone in preventing death or low cardiac output syndrome in children undergoing surgery for congenital heart disease, compared to placebo. So far, no differences have been shown between milrinone and other inodilators, such as levosimendan or dobutamine, in the immediate postoperative period, in reducing the risk of LCOS or death. The existing data on the prophylactic use of milrinone has to be viewed cautiously due to the small number of small trials and their risk of bias.

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Conflict of interest statement

Barbara E.U. Burkhardt: Joined the institution where one of the trials had been conducted (Cavigelli 2013) seven months after identifying the study for this review in a clinical trial database. The study had already been finished by then, and this author was not involved in its conduct. Eight months later, it was published as an abstract, again without this author's involvement.

Brigitte Stiller: none known.

Gerta Rücker: none known.

Figures

1
1
Study flow diagram
2
2
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
4
4
Forest plot of comparison: 1 Mortality, outcome: 1.1 Mortality milrinone versus levosimendan, Constant Continuity Correction. event.e = event in experimental group; n.e. = non‐event in experimental group; incr.e. = increment experimental group. event.c = event in control group; n.c. = non‐event in control group; incr.c. = increment control group.
5
5
Forest plot of comparison: 1 Mortality, outcome: 1.1 Mortality milrinone versus levosimendan, Treatment Arm Continuity Correction. event.e = event in experimental group; n.e. = non‐event in experimental group; incr.e. = increment experimental group. event.c = event in control group; n.c. = non‐event in control group; incr.c. = increment control group.
1.1
1.1. Analysis
Comparison 1 Mortality, Outcome 1 Mortality milrinone versus levosimendan.
2.1
2.1. Analysis
Comparison 2 LCOS, Outcome 1 LCOS.
3.1
3.1. Analysis
Comparison 3 Intensive Care Unit stay, Outcome 1 Duration of ICU stay.
4.1
4.1. Analysis
Comparison 4 Hospital stay, Outcome 1 Duration of hospital stay.
5.1
5.1. Analysis
Comparison 5 Mechanical ventilation, Outcome 1 Duration of mechanical ventilation.
6.1
6.1. Analysis
Comparison 6 Inotrope score, Outcome 1 Maximum inotrope score.
7.1
7.1. Analysis
Comparison 7 Arrhythmia, Outcome 1 Arrhythmia.
8.1
8.1. Analysis
Comparison 8 Thrombocytopenia, Outcome 1 Thrombocytopenia.
9.1
9.1. Analysis
Comparison 9 Pleural effusion, Outcome 1 Pleural effusion.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Cavigelli 2013 {published and unpublished data}
    1. Cavigelli‐Brunner A, Hug MI, Dave H, Cannizzaro V, Baenziger O, Buerki C, et al. Therapy of low cardiac output syndrome after cardiac surgery in infants and children: a double blind randomized study comparing dobutamine and milrinone. Cardiology in the Young. May 2013; Vol. 23, Supplement S1:S34; O11‐3.
Hoffman (HD vs. placebo) {published and unpublished data}
    1. Hoffman TM, Wernovsky G, Atz AM, Bailey JM, Akbary A, Kocsis JF, et al. Prophylactic intravenous use of milrinone after cardiac operation in pediatrics (PRIMACORP) study. American Heart Journal 2002;143(1):15‐21. - PubMed
    1. Hoffman TM, Wernovsky G, Atz AM, Kulik TJ, Nelson DP, Chang AC, et al. Efficacy and safety of milrinone in preventing low cardiac output syndrome in infants and children after corrective surgery for congenital heart disease. Circulation 2003;107(7):996‐1002. - PubMed
Hoffman (LD vs. placebo) {published and unpublished data}
    1. Hoffman TM, Wernovsky G, Atz AM, Bailey JM, Akbary A, Kocsis JF, et al. Prophylactic intravenous use of milrinone after cardiac operation in pediatrics (PRIMACORP) study. American Heart Journal 2002;143(1):15‐21. - PubMed
    1. Hoffman TM, Wernovsky G, Atz AM, Kulik TJ, Nelson DP, Chang AC, et al. Efficacy and safety of milrinone in preventing low cardiac output syndrome in infants and children after corrective surgery for congenital heart disease. Circulation 2003;107(7):996‐1002. - PubMed
Hoffman 2003 {published and unpublished data}
    1. Hoffman TM, Wernovsky G, Atz AM, Bailey JM, Akbary A, Kocsis JF, et al. Prophylactic intravenous use of milrinone after cardiac operation in pediatrics (PRIMACORP) study.. American Heart Journal 2002;143(1):15‐21. - PubMed
    1. Hoffman TM, Wernovsky G, Atz AM, Kulik TJ, Nelson DP, Chang AC, et al. Efficacy and safety of milrinone in preventing low cardiac output syndrome in infants and children after corrective surgery for congenital heart disease. Circulation 2003;107(7):996‐1002. - PubMed
Lechner 2012 {published and unpublished data}
    1. Lechner E, Hofer A, Leitner‐Peneder G, Freynschlag R, Mair R, Weinzettel R, et al. Levosimendan versus milrinone in neonates and infants after corrective open‐heart surgery: a pilot study. Pediatric Critical Care Medicine 2012;13(5):542‐8. - PubMed
Momeni 2011 {published data only}
    1. Momeni M, Rubay J, Matta A, Rennotte MT, Veyckemans F, Poncelet AJ, et al. Levosimendan in congenital cardiac surgery: a randomized, double‐blind clinical trial. Journal of Cardiothoracic and Vascular Anesthesia 2011;25(3):419‐24. - PubMed
Pellicer 2013 {published data only}
    1. Pellicer A, Riera J, Lopez‐Ortego P, Bravo MC, Madero R, Perez‐Rodriguez J, et al. Phase 1 study of two inodilators in neonates undergoing cardiovascular surgery. Pediatric Research 2013;73(1):95‐103. - PubMed

References to studies excluded from this review

Bailey 2004 {published data only}
    1. Bailey JM, Hoffman TM, Wessel DL, Nelson DP, Atz AM, Chang AC, et al. A population pharmacokinetic analysis of milrinone in pediatric patients after cardiac surgery. Journal of Pharmacokinetics and Pharmacodynamics 2004;31(1):43‐59. - PubMed
Cai 2008a {published data only}
    1. Cai J, Su Z, Shi Z, Zhou Y, Xu Z, Xu Z, et al. Nitric oxide and milrinone: combined effect on pulmonary circulation after Fontan‐type procedure: a prospective, randomized study. Annals of Thoracic Surgery 2008;86(3):882‐8. - PubMed
Cai 2008b {published data only}
    1. Cai J, Su Z, Shi Z, Zhou Y, Xu Z, Liu J, et al. Nitric oxide in conjunction with milrinone better stabilized pulmonary hemodynamics after Fontan procedure. Artificial Organs 2008;32(11):864‐9. - PubMed
Carmona 2010 {published data only}
    1. Carmona MJ, Martins LM, Vane MF, Longo BA, Paredes LS, Malbouisson LM. Comparison of the effects of dobutamine and milrinone on hemodynamic parameters and oxygen supply in patients undergoing cardiac surgery with low cardiac output after anesthetic induction. Revista Brasileira de Anestesiologia 2010;60(3):237‐46. - PubMed
Doolan 1997 {published data only}
    1. Doolan LA, Jones EF, Kalman J, Buxton BF, Tonkin AM. A placebo‐controlled trial verifying the efficacy of milrinone in weaning high‐risk patients from cardiopulmonary bypass. Journal of Cardiothoracic and Vascular Anesthesia 1997;11(1):37‐41. - PubMed
Farah 2013 {published data only}
    1. Farah P, Ahmad‐Ali A, Hanane G, Abbas E. Additive effect of phosphodiesterase inhibitors in control of pulmonary hypertension after congenital cardiac surgery in children. Iranian Journal of Pediatrics 2013;23(1):19‐26. - PMC - PubMed
Khazin 2004 {published data only}
    1. Khazin V, Kaufman Y, Zabeeda D, Medalion B, Sasson L, Schachner A, et al. Milrinone and nitric oxide: combined effect on pulmonary artery pressures after cardiopulmonary bypass in children. Journal of Cardiothoracic and Vascular Anesthesia 2004;18(2):156‐9. - PubMed
Maslow 2004 {published data only}
    1. Maslow AD, Regan MM, Schwartz C, Bert A, Singh A. Inotropes improve right heart function in patients undergoing aortic valve replacement for aortic stenosis. Anesthesia and Analgesia 2004;98(4):891‐902. - PubMed
Oztekin 2007 {published data only}
    1. Oztekin I, Yazici S, Oztekin DS, Goksel O, Issever H, Canik S. Effects of low‐dose milrinone on weaning from cardiopulmonary bypass and after in patients with mitral stenosis and pulmonary hypertension. Yakugaku Zasshi 2007;127(2):375‐83. - PubMed
Ricci 2012 {published data only}
    1. Ricci Z, Garisto C, Favia I, Vitale V, Chiara L, Cogo PE. Levosimendan infusion in newborns after corrective surgery for congenital heart disease: randomized controlled trial. Intensive Care Medicine 2012;38(7):1198‐204. - PubMed
Thul 1999 {published data only}
    1. Thul J, Hundt F, Will J, Schindler F, Akintürk H, Valeske K, et al. Enoximon vs. milrinon by myocardial dysfunction after cardio‐surgical operations in infants. Zeitschrift fur Kardiologie 1999;88(9):758. [CN‐00340079]
Zuppa 2006 {published data only}
    1. Zuppa AF, Nicolson SC, Adamson PC, Wernovsky G, Mondick JT, Burnham N, et al. Population pharmacokinetics of milrinone in neonates with hypoplastic left heart syndrome undergoing stage I reconstruction. Anesthesia and Analgesia 2006;102(4):1062‐9. - PubMed

References to studies awaiting assessment

Costello 2014 {published data only}
    1. Costello JM, Dunbar‐Masterson C, Allan CK, Gauvreau K, Newburger JW, McGowan FX Jr, et al. Impact of empiric nesiritide or milrinone infusion on early postoperative recovery after Fontan surgery: a randomized, double‐blind, placebo‐controlled trial. Circulation Heart Failure 2014;7(4):596‐604. - PubMed
    1. Costello JM, Masterson CD, Allan CK, Gauvreau K, Newburger JW, McGowan FX, et al. Impact of empiric nesiritide or milrinone infusion on early postoperative recovery following fontan surgery: A randomized, double‐blind, placebo‐controlled clinical trial. Circulation. 2013; Vol. 128(22 suppl):A12099. - PubMed

Additional references

Abraham 2005
    1. Abraham WT, Adams KF, Fonarow GC, Costanzo MR, Berkowitz RL, LeJemtel TH, et al. In‐hospital mortality in patients with acute decompensated heart failure requiring intravenous vasoactive medications: an analysis from the Acute Decompensated Heart Failure National Registry (ADHERE). Journal of the American College of Cardiology 2005;46(1):57‐64. - PubMed
Allen 2014
    1. Allen LA, Fonarow GC, Grau‐Sepulveda MV, Hernandez AF, Peterson PN, Partovian C, et al. Hospital variation in intravenous inotrope use for patients hospitalized with heart failure: insights from Get With The Guidelines. Circulation Heart Failure 2014;7(2):251‐60. - PMC - PubMed
Alousi 1986
    1. Alousi AA, Johnson DC. Pharmacology of the bipyridines: amrinone and milrinone. Circulation 1986;73(3 Pt 2):III10‐24. - PubMed
Anonymous 2011
    1. Anonymous. Heads of Medicines Agencies EU worksharing procedure for assessment of paediatric data for milrinone. http://www.hma.eu/fileadmin/dateien/Human_Medicines/CMD_h_/Paediatric_Re... 06/07/2011.
Bailey 1999
    1. Bailey JM, Miller BE, Lu W, Tosone SR, Kanter KR, Tam VK. The pharmacokinetics of milrinone in pediatric patients after cardiac surgery. Anesthesiology 1999;90(4):1012‐8. - PubMed
Bassler 2006
    1. Bassler D, Choong K, McNamara P, Kirpalani H. Neonatal persistent pulmonary hypertension treated with milrinone: four case reports. Biology of the Neonate 2006;89(1):1‐5. - PubMed
Baysal 2010
    1. Baysal A, Saşmazel A, Yıldırım Aİ, Koçak T, Sunar H, Zeybek R. The effects of thyroid hormones and interleukin‐8 levels on prognosis after congenital heart surgery [Doğuştan kalp cerrahisinde tiroit fonksiyonları ve interlökin‐8 değerlerinin prognoz üzerine etkisi.]. Turk Kardiyoloji Dernegi Arsivi 2010;38(8):537‐43. - PubMed
Bohn 2011
    1. Bohn D. Objective assessment of cardiac output in infants after cardiac surgery. Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 2011;14(1):19‐23. - PubMed
Charpie 2000
    1. Charpie JR, Dekeon MK, Goldberg CS, Mosca RS, Bove EL, Kulik TJ. Serial blood lactate measurements predict early outcome after neonatal repair or palliation for complex congenital heart disease. Journal of Thoracic and Cardiovascular Surgery 2000;120(1):73‐80. - PubMed
Delmo Walter 2010
    1. Delmo Walter EM, Alexi‐Meskishvili V, Huebler M, Loforte A, Stiller B, Weng Y, et al. Extracorporeal membrane oxygenation for intraoperative cardiac support in children with congenital heart disease. Interactive Cardiovascular and Thoracic Surgery 2010;10(5):753‐8. - PubMed
Dilber 2010
    1. Dilber D, Malcić I. Spectrum of congenital heart defects in Croatia. European Journal of Pediatrics 2010 May;169(5):543‐50. - PubMed
EACTS 2011
    1. EACTS Congenital Database [European Association for Cardio‐Thoracic Surgery Congenital Database]. http://www.eactscongenitaldb.org 31.08.2011.
el Allaf 1984
    1. Allaf D, D'Orio V, Carlier J. The new inotropic phosphodiesterase inhibitors. Archives of Physiology and Biochemistry 1984;92(4):S69‐79. - PubMed
Ermis 2011
    1. Ermis PR, Morales DL. The adult Fontan patient: update for 2011. Methodist Debakey Cardiovascular Journal 2011;7(2):3‐8. - PubMed
Feneck 1992
    1. Feneck RO. Intravenous milrinone following cardiac surgery: I. Effects of bolus infusion followed by variable dose maintenance infusion. The European Milrinone Multicentre Trial Group. Journal of Cardiothoracic and Vascular Anesthesia 1992;6(5):554‐62. - PubMed
Fleming 2008
    1. Fleming GA, Murray KT, Yu C, Byrne JG, Greelish JP, Petracek MR, et al. Milrinone use is associated with postoperative atrial fibrillation after cardiac surgery. Circulation 2008;118(16):1619‐25. - PMC - PubMed
Follath 2011
    1. Follath F, Yilmaz MB, Delgado JF, Parissis JT, Porcher R, Gayat E, et al. Clinical presentation, management and outcomes in the Acute Heart Failure Global Survey of Standard Treatment (ALARM‐HF). Intensive Care Medicine 2011;37(4):619‐26. - PubMed
Harbord 2006
    1. Harbord RM, Egger M, Sterne JA. A modified test for small‐study effects in meta‐analyses of controlled trials with binary endpoints. Statistics in Medicine 2006;25(20):3443‐57. - PubMed
Higgins 2002
    1. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta‐analysis. Statistics in Medicine 2002;21(11):1539‐58. - PubMed
Higgins 2011
    1. Higgins JPT, Altman DG, Sterne JAC. Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S (editors).Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Hochman 1999
    1. Hochman JS, Sleeper LA, Webb JG, Sanborn TA, White HD, Talley JD, et al. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK Investigators. Should we emergently revascularize occluded coronaries for cardiogenic shock. New England Journal of Medicine 1999;341(9):625‐34. - PubMed
Huntsman 1983
    1. Huntsman LL, Stewart DK, Barnes SR, Franklin SB, Colocousis JS, Hessel EA. Noninvasive Doppler determination of cardiac output in man. Clinical validation. Circulation 1983;67(3):593‐602. - PubMed
Jeon 2006
    1. Jeon Y, Ryu JH, Lim YJ, Kim CS, Bahk JH, Yoon SZ, et al. Comparative hemodynamic effects of vasopressin and norepinephrine after milrinone‐induced hypotension in off‐pump coronary artery bypass surgical patients. European Journal of Cardiothoracic Surgery 2006;29(6):952‐6. - PubMed
Kim 2006
    1. Kim J, Dreyer J, Chang A. Arterial pulse wave analysis: an accurate means of determining cardiac output in children. Pediatric Critical Care Medicine 2006;7:532–5. - PubMed
Lefebvre, 2011
    1. Lefebvre C, Manheimer E, Glanville J. Chapter 6: Searching for studies. In: Higgins JPT, Green S (editors).Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Lemson 2008
    1. Lemson J, Boode WP, Hopman JC, Singh SK, Hoeven JG. Validation of transpulmonary thermodilution cardiac output measurement in a pediatric animal model. Pediatric Critical Care Medicine 2008;9(3):313‐9. - PubMed
Lindinger 2010
    1. Lindinger A, Schwedler G, Hense HW. Prevalence of congenital heart defects in newborns in Germany: Results of the first registration year of the PAN Study (July 2006 to June 2007) [Prävalenz angeborener Herzfehler bei Neugeborenen in Deutschland: Ergebnisse des ersten Geburtsjahrganges (Juli 2006 bis Juni 2007)]. Klinische Pädiatrie 2010;222(5):321‐6. - PubMed
MHRA 2005
    1. Medicines and Healthcare Products Regulatory Agency (UK), Paediatric Working Party ‐ Committee on Safety of Medicines. Review of paediatric data ‐ Primacor Injection. http://www.mhra.gov.uk/home/groups/pl‐p/documents/websiteresources/con20... 2005, Apr 27; Vol. Accessed 2014, Sep 11.
Moffett 2015
    1. Moffett BS, Price JF. National prescribing trends for heart failure medications in children. Congenital Heart Disease 2015;10(1):78‐85. [DOI: 10.1111/chd.12183] - DOI - PubMed
Moher 2009
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta‐analyses: the PRISMA statement. BMJ 2009;339:b2535. - PMC - PubMed
Nieminen 2006
    1. Nieminen MS, Brutsaert D, Dickstein K, Drexler H, Follath F, Harjola VP, et al. EuroHeart Failure Survey II (EHFS II): a survey on hospitalized acute heart failure patients: description of population. European Heart Journal 2006;27(22):2725‐36. - PubMed
Paradisis 2009
    1. Paradisis M, Evans N, Kluckow M, Osborn D. Randomized trial of milrinone versus placebo for prevention of low systemic blood flow in very preterm infants. Journal of Pediatrics 2009;154(2):189‐95. - PubMed
Pasquali 2008
    1. Pasquali SK, Hall M, Slonim AD, Jenkins KJ, Marino BS, Cohen MS, et al. Off‐label use of cardiovascular medications in children hospitalized with congenital and acquired heart disease. Circulation: Cardiovascular Quality and Outcomes 2008;1(2):74‐83. - PubMed
R 2013 [Computer program]
    1. R Development Core Team. R: A Language and Environment for Statistical Computing. Vienna 2013. Vienna: R Foundation, 2013.
Ramamoorthy 1998
    1. Ramamoorthy C, Anderson GD, Williams GD, Lynn AM. Pharmacokinetics and side effects of milrinone in infants and children after open heart surgery. Anesthesia and Analgesia 1998;86(2):283‐9. - PubMed
Rao 1996
    1. Rao V, Ivanov J, Weisel RD, Ikonomidis JS, Christakis GT, David TE. Predictors of low cardiac output syndrome after coronary artery bypass. Journal of Thoracic and Cardiovascular Surgery 1996;112(1):38‐51. - PubMed
Rücker 2011
    1. Rücker G, Schwarzer G, Carpenter JR, Binder H, Schumacher M. Treatment‐effect estimates adjusted for small‐study effects via a limit meta‐analysis. Biostatistics 2011;12(1):122‐42. - PubMed
Sanofi Aventis 2010
    1. Sanofi Aventis. Drug reference Corotrop® (Milrinone) [Fachinformation Corotrop®]. Rote Liste® Service GmbH • Mainzer Landstr. 55 • 60329 Frankfurt/Main August 2010.
Schwarzer 2007
    1. Schwarzer G. meta: An R package for Meta‐Analysis. R News 2007;7(3):40‐5.
Schwarzer 2010
    1. Schwarzer G, Rücker G. Statistical methods for detecting and adjusting for publication bias. Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen (ZEFQ) 2010;104(4):306‐13. - PubMed
Shi 2008
    1. Shi S, Zhao Z, Liu X, Shu Q, Tan L, Lin R, et al. Perioperative risk factors for prolonged mechanical ventilation following cardiac surgery in neonates and young infants. Chest 2008;134(4):768‐74. - PubMed
Shore 2001
    1. Shore S, Nelson DP, Pearl JM, Manning PB, Wong H, Shanley TP, et al. Usefulness of corticosteroid therapy in decreasing epinephrine requirements in critically ill infants with congenital heart disease. American Journal of Cardiology 2001;88(5):591‐4. - PubMed
Stocker 2006
    1. Stocker CF. Recent developments in the perioperative management of the paediatric cardiac patient. Current Opinion in Anaesthesiology 2006;19(4):375‐81. - PubMed
Stocker 2007
    1. Stocker CF, Shekerdemian LS, Nørgaard MA, Brizard CP, Mynard JP, Horton SB, et al. Mechanisms of a reduced cardiac output and the effects of milrinone and levosimendan in a model of infant cardiopulmonary bypass. Critical Care Medicine 2007;35(1):252‐9. - PubMed
Sweeting 2004
    1. Sweeting MJ, Sutton AJ, Lambert PC. What to add to nothing? Use and avoidance of continuity corrections in meta‐analysis of sparse data. Statistics in Medicine 2004;23(9):1351‐75. - PubMed
Teng 2011
    1. Teng S, Kaufman J, Pan Z, Czaja A, Shockley H, Cruz E. Continuous arterial pressure waveform monitoring in pediatric cardiac transplant, cardiomyopathy and pulmonary hypertension patients. Intensive Care Medicine 2011;37(8):1297‐301. - PubMed
Tibby 2002
    1. Tibby SM, Murdoch IA. Measurement of cardiac output and tissue perfusion. Current Opinion in Pediatrics 2002;14:303–9. - PubMed
Tierney 2007
    1. Tierney JF, Stewart LA, Ghersi D, Burdett S, Sydes MR. Practical methods for incorporating summary time‐to‐event data into meta‐analysis. Trials 2007;8:16. - PMC - PubMed
Vogt 2011a
    1. Vogt W, Läer S. Treatment for paediatric low cardiac output syndrome: results from the European EuLoCOS‐Paed survey. Archives of Disease in Childhood 2011;96(12):1180‐6. - PubMed
Vogt 2011b
    1. Vogt W, Läer S. Prevention for pediatric low cardiac output syndrome: results from the European survey EuLoCOS‐Paed. Paediatric Anaesthesia 2011;21(12):1176‐84. - PubMed
Warnes 2001
    1. Warnes CA, Liberthson R, Danielson GK, Dore A, Harris L, Hoffman JI, et al. Task force 1: the changing profile of congenital heart disease in adult life. Journal of the American College of Cardiology 2001;37(5):1170‐5. - PubMed

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