milrinone / Generic mfg. - LARVOL DELTA

Inhaled Milrinone in Weaning from Cardiopulmonary Bypass: A Case Study. (PubMed, AANA J) - "We report the case of a 55-year-old male undergoing aortic valve replacement and left atrial appendage ligation who successfully separated from CPB after receiving inhaled milrinone. Improvement in pulmonary artery pressures, central venous pressure, and cardiac output contributed to a smooth postoperative course."

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure • Hypertension • Hypotension • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases

A deep representation learning algorithm on drug-target interaction to screen novel drug candidates for Alzheimer's disease. (PubMed, Artif Intell Med) - "Our results identified that several drugs could be promising for AD treatment, including human C1-esterase inhibitor, quetiapine, dasatinib, miconazole, aniracetam, chlorpromazine, hypericin, entrectinib, torcetrapib, bosutinib, sunitinib, aniracetam, rosiglitazone, tarenflurbil, milrinone, and MITO-4509. Results from this study also provided insights for understanding the molecular mechanisms underlying AD. As a systematic and versatile method, our approach can also be applied to identify efficacious therapies for other complex diseases."

Journal • Alzheimer's Disease • CNS Disorders

Milrinone in Advanced Heart Failure: Current Evidence, Clinical Applications, and Future Directions. (PubMed, Cardiol Rev) - "Milrinone is one of the most common inotropic agents used in advanced heart failure to provide symptomatic relief and improved hemodynamics. This review discusses the current evidence of milrinone's efficacy, indications, outcomes in advanced heart failure, evidence gap, and future directions."

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure • Palliative care • Transplantation

The effect of milrinone on short- and mid-term outcomes in patients with sepsis-related myocardial injury: A propensity score matched retrospective study. (PubMed, Heart Lung) - "Milrinone treatment may improve long-term survival rates in patients with sepsis-related myocardial injury. Future research should focus on refining treatment protocols and tailoring therapeutic approaches based on individual patient characteristics."

Journal • Retrospective data • Infectious Disease • Septic Shock

Impact of cerebral vasospasm therapy on nimodipine exposure in subarachnoid hemorrhage: A population pharmacokinetic study. (PubMed, J Neurol Sci) - "Hemodynamic augmentation therapy per se did not significantly affect [Nimodipine]plasma in contrast to patient's BSA, and, to a clinically irrelevant extent, MAP level."

Journal • PK/PD data • Cardiovascular • Hematological Disorders • Hypertension • Pulmonary Arterial Hypertension • Subarachnoid Hemorrhage

Utilization patterns and determinants of guideline-recommended therapies for acute heart failure in Denmark. (PubMed, Eur Heart J Acute Cardiovasc Care) - "Loop diuretics were widely used, while vasodilators, inotropes, and vasopressors had lower utilization. The observed variation in treatment reflects complexity of inpatient AHF management, warranting further studies to assess treatment outcomes."

Journal • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Heart Failure • Nephrology • Renal Disease

Can Milrinone Be a Therapeutic Alternative in Persistent Pulmonary Hypertension of the Newborn? A Case Series and Narrative Review. (PubMed, Pediatr Rep) - "Milrinone may serve as a feasible adjunct or bridging therapy for PPHN when iNO is unavailable. However, its use requires careful hemodynamic and neurological monitoring, particularly in very preterm infants. Further studies are needed to confirm safety and define optimal dosing across gestational ages."

Journal • Cardiovascular • Hematological Disorders • Hypertension • Hypotension • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases

Twelve-Month Survival on Chronic Continuous Milrinone Infusion and Proarrhythmic Complications: A Case Report and Literature Review. (PubMed, Cureus) - "Outpatient milrinone infusion offers meaningful symptomatic relief and possibly extended survival in patients with advanced heart failure. Larger prospective studies are needed to define the true benefit-risk profile and mortality outcomes of chronic inotropic therapy."

Journal • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Fibrosis • Gastroenterology • Heart Failure • Hepatology • Immunology • Infectious Disease • Liver Cirrhosis • Novel Coronavirus Disease • Pneumonia • Respiratory Diseases • Transplantation • Ventricular Tachycardia

Cardiac Cachexia: A Case of Esophageal Compression (AHA 2025) - "The patient was started on a milrinone infusion and treated with intravenous bumetanide.A nasogastric feeding tube was inserted for tube feeds. As the patient also suffers chronic heart failure, cardiac cachexia was likely a significant contributor to the patient's weight loss. Early recognition and intervention are crucial to improving quality of life and survival."

Clinical • Atrial Fibrillation • Cachexia • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Gastrointestinal Disorder • Heart Failure • Hypertrophic Cardiomyopathy • Obstructive Hypertrophic Cardiomyopathy • Pulmonary Disease

Opportunistic PK/PD Trial in Critically Ill Children (OPTIC) (clinicaltrials.gov) - P=N/A | N=2000 | Recruiting | Sponsor: Duke University | Trial completion date: Oct 2026 ➔ Oct 2028 | Trial primary completion date: Oct 2025 ➔ Oct 2027

Trial completion date • Trial primary completion date • Heart Failure

Hypertonic Saline as Adjunct for Diuretic Resistance in Cardiorenal Syndrome (KIDNEY WEEK 2025) - "Case Description A 77-year-old female with a history of chronic heart failure with reduced ejection fraction, type 2 diabetes mellitus, and atrial fibrillation on rivaroxaban presented as a trauma alert after a mechanical fall...Intravenous furosemide and milrinone were initiated, and SNB was employed with the addition of acetazolamide and hydrochlorothiazide...Another less known mechanism is contributing to the restoration of the medullary osmotic gradient, often disrupted in ATN, thereby promoting natriuresis and free water clearance. In conclusion, hypertonic saline represents a viable adjunctive strategy in the management of diuretic-resistant volume overload."

Acute Kidney Injury • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Diabetes • Heart Failure • Metabolic Disorders • Musculoskeletal Diseases • Nephrology • Orthopedics • Pulmonary Embolism • Renal Disease • Respiratory Diseases • Type 2 Diabetes Mellitus

Clinical Importance of Phosphodiesterase 3 Inhibitors on Outcomes in Patients With Cardiogenic Shock　- A Systematic Review. (PubMed, Circ Rep) - "One RCT compared milrinone with dobutamine (DOB), and another compared enoximone with levosimendan. Meta-analysis revealed that PDE3i were neither superior nor inferior for the outcomes in the total cohort (odds ratio [OR] 1.47, 95% confidence interval [CI] 0.35-6.26 for early deaths; OR 1.14, 95% CI 0.42-3.14 for cardiac arrest; OR 1.53, 95% CI 0.80-2.92 for the initiation of renal replacement therapy). The present systematic review revealed no difference in outcomes, early deaths, cardiac arrest and initiation of renal replacement therapy when using PDE3i in patients with CS treated with or without other inotropes."

Journal • Cardiovascular

Milrinone in Congenital Diaphragmatic Hernia (clinicaltrials.gov) - P2 | N=66 | Completed | Sponsor: NICHD Neonatal Research Network | Active, not recruiting ➔ Completed

Trial completion • Cardiovascular • Gastroenterology • Hypertension • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases

Use of milrinone in pediatric intensive care units: a multicenter survey of French-speaking countries. (PubMed, Eur J Pediatr) - "There are a lack of a clear guidance and recommendations for the use of milrinone in critically ill children despite its frequent and widespread use. Further prospective studies and research are mandatory to improve and tailor milrinone use in critically ill neonates and children."

Journal • Cardiovascular • Congestive Heart Failure • Critical care • Heart Failure • Hypertension • Pediatrics • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases

Post-traumatic vasospasm: Epidemiology, specificities, risk factors, and therapeutics. (PubMed, J Intensive Med) - "Treatment options include nimodipine and endovascular therapies, such as angioplasty and milrinone, though these require careful management due to their invasive nature and potential hypotensive effect. Although current strategies, such as nimodipine and intra-arterial therapies, have shown promise, further research is needed to refine these approaches and improve outcomes. Enhanced understanding of PTV's pathophysiology, along with the development of more effective diagnostic and therapeutic tools, is essential for advancing patient care in TBI."

Journal • Review • Cardiovascular • CNS Disorders • Giant Cell Arteritis • Hematological Disorders • Subarachnoid Hemorrhage • Vascular Neurology

Cardiogenic Shock due to Flecainide Toxicity: No substitute for time. (AHA 2025) - "Treatment of flecainide toxicity included sodium bicarbonate boluses, anti-tachycardia pacing, synchronized cardioversion, and amiodarone infusion...Cardiogenic shock was managed with bumetanide infusion and placement of an intra-aortic balloon pump...The patient did not tolerate milrinone due to hypotension and tachycardia...None of the antiarrhythmic strategies were immediately successful at restoring sinus rhythm. Ultimately, the most successful strategy was tincture of time to allow for flecainide clearance and the patient recovered."

Acute Kidney Injury • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Heart Failure • Hypotension • Nephrology • Pulmonary Disease • Renal Disease

A Case of Steroid-Refractory Immune-checkpoint-inhibitor Induced Myocarditis Responsive to Mycophenolate and Anti-thymocyte globulin (AHA 2025) - "Introduction: Pembrolizumab, an immune checkpoint inhibitor (ICI), is a monoclonal antibody that binds to PD-1 receptors on T-cells and prevents their inhibition by certain tumors, augmenting the immune system's ability to kill malignant cells...In follow-up, dyspnea and weight gain were noted, HSTn-T was persistently elevated to 208 ng/L despite interval increase in prednisone.On readmission, he was found to be in cardiogenic shock requiring milrinone with a lactate of 3.9 and HSTn-T of 142 ng/L...He received a 3-day course of methylprednisolone 1g IV followed by prednisone and a 5-day course of rabbit anti-thymocyte globulin (Thymoglobulin). As he completed the thymoglobulin, his symptoms improved and mycophenolate mofetil (MMF) was added...High dose steroids are the standard of treatment for ICI-myocarditis, leading to improved outcomes with respect to cardiovascular death, cardiac arrest, and cardiogenic shock. However, data is sparse on treatment options when..."

Checkpoint inhibition • Clinical • Cardiovascular • CNS Disorders • Fibrosis • Inflammation • Oncology • Oral Cancer • Pulmonary Disease • Squamous Cell Carcinoma • Thrombosis • Tongue Carcinoma

A Shocking Postpartum Course (AHA 2025) - "She started aspirin 81 mg daily and discharged after 3 days of observation...Postoperative EF was estimated at 15%-20% and she started on milrinone...She discharged home on low dose losartan, spironolactone, metoprolol, and digoxin...Our patient's ability to wean off Impella support and inotropes prior to discharge raises the question if Impella support alone could temporize cardiogenic shock due to SCAD in lieu of Impella support combined with operative management. Further research is needed to define best practices for management of cardiogenic shock due to SCAD."

Cardiovascular • Congestive Heart Failure • Coronary Artery Disease • Heart Failure

A Hidden Threat: Trazodone-Induced Warfarin Failure Leading to Acute Mechanical Aortic Valve Thrombosis (AHA 2025) - "Due to prohibitive surgical risk, thrombolysis with alteplase (25 mg over 6 hours) was administered...He was stabilized on milrinone and extubated by hospital day five.Despite restarting warfarin—at doses up to 30 mg daily (three times his prior regimen)—therapeutic INR was not achieved until 10 days later...While the exact mechanism is unclear, proposed theories include CYP2C9 induction, increased warfarin clearance, or protein-binding displacement. This case highlights the need for close INR monitoring when initiating trazodone in patients on warfarin."

Acute Respiratory Distress Syndrome • Back Pain • Cardiovascular • Cough • Hematological Disorders • Hepatology • Infectious Disease • Liver Failure • Musculoskeletal Pain • Pneumonia • Pulmonary Disease • Respiratory Diseases • Septic Shock • Thrombosis • CYP2C9

Advanced Heart Failure and Mechanical Circulatory Support in the Context of Incarceration: A Clinical Challenge (AHA 2025) - "Workup showed a renal infarct (presumed cardioembolic), EF 8%, biventricular dysfunction, and cardiogenic shock despite cardioversion and rhythm control requiring norepinephrine (0.5 mcg/kg/min), epinephrine (0.1 mcg/kg/min), and dobutamine (2.5 mcg/kg/min)...He was transitioned to milrinone with clinical improvement and discharged to his correctional facility with plans for reassessment for advanced options following expected imminent prison release...Infection risk and security concerns further complicate care. Addressing these challenges are essential to ensure that incarcerated individuals receive equitable access to advanced heart failure therapies and thus facilitate optimal outcomes."

Clinical • Metastases • Atrial Fibrillation • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Heart Failure • Hypotension • Infectious Disease • Pulmonary Disease

Routine Use of Epicardial Atrial Pacing After Cardiac Surgery: Impact on In-Hospital Outcomes in a Community Hospital in Argentina (AHA 2025) - "Intraoperative inotrope use was more frequent in the EAP group: norepinephrine (64.1% vs. 45.6%; p = 0.02), dobutamine (13.5% vs. 6%; p = 0.047), and milrinone (16% vs. 8.1%; p = 0.05). Routine epicardial atrial pacing following cardiac surgery was not associated with improved in-hospital clinical outcomes. While its primary indication remains postoperative rhythm disturbances, its use may be justified in selected patients—particularly older individuals or those requiring intraoperative inotropic support—based on clinical judgment. Importantly, the procedure demonstrated a favorable safety profile."

Clinical • Surgery • Cardiovascular

Milrinone Associated with Lower Mortality and Higher Arrhythmia Risk in Comparison to Dobutamine in End-Stage Heart Failure Without Renal Dysfunction (AHA 2025) - "In patients with end-stage heart failure and preserved renal function, milrinone was associated with lower all-cause mortality but increased arrhythmia risk over longer follow-up. These findings indicate that there may be underlying outcome differences between inotropic choices for certain patient populations, and prospective trials are warranted."

Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Heart Failure • Nephrology • Palliative care • Renal Disease

Late Presentation Myocardial Infarction With Dueling Mechanical Complications: Dynamic Left Ventricular Outflow Tract Obstruction (LVOTO) and Ventricular Septal Rupture (VSR) (AHA 2025) - "She was admitted to the CCU, where shock improved with norepinephrine, milrinone, and IV diuresis.Her course was complicated by new-onset atrial fibrillation with RVR. Despite IV amiodarone, RVR persisted, along with worsening respiratory status and increasing vasopressors needs...Esmolol was considered to reduce the gradient...The presence of dual complications—dynamic LVOTO and VSR—illustrates the clinical complexity. This case also highlights key decision points regarding temporary mechanical circulatory support and the need to weigh aggressive interventions against patient goals in frail, multi-morbid individuals, where benefit to quality of life and survival may be limited."

Atrial Fibrillation • Autoimmune Hepatitis • B Cell Lymphoma • Cardiovascular • Cough • Hematological Malignancies • Hepatology • Immunology • Infectious Disease • Lymphoma • Metabolic Disorders • Myocardial Infarction • Non-Hodgkin’s Lymphoma • Palliative care • Pulmonary Disease • Respiratory Diseases

Vasoactive medications in the management of normotensive cardiogenic shock: patient factors and provider choices affecting the likelihood of mortality (AHA 2025) - "Those who were older, received more VMs, and received milrinone or dobutamine prior to an elevated lactate had a lower likelihood of survival (ARR -0.27, p= 0.036, Figure 1b and 1c). In this single-center retrospective study of predictors of survival in normotensive CS, the interaction of being younger, having a lower SOFA score, and receiving nitroprusside as first VM conferred a higher chance of survival. VM choice should be further investigated in a larger, multisite cohort to inform VM treatment recommendations."

Clinical • Cardiovascular • Congestive Heart Failure • Heart Failure

Partial Anomalous Pulmonary Venous Return: An Uncommon Cause of Refractory Hypoxemia Following Coronary Artery Bypass Grafting (AHA 2025) - "Treatment with milrinone, inhaled nitric oxide, and inhaled epoprostenol led to significant hemodynamic and oxygenation improvement. PAPVR, though rare, should be a part of differential diagnosis in persistent hypoxemia and right ventricular dysfunction after CABG. Early recognition through multimodal imaging, including CT and TEE, is critical. ECMO may be necessary for stabilization while pursuing definitive surgical management."

Cardiovascular • Coronary Artery Disease • Diabetes • Gastroenterology • Gastroesophageal Reflux Disease • Genetic Disorders • Heart Failure • Metabolic Disorders • Myocardial Infarction • Obesity • Pulmonary Disease • Respiratory Diseases