Dobutamine Versus Milrinone in Management of Critically Ill Low Cardiac Output Pediatric Patients at Cairo University Children's Hospital
Dobutamine, Milrinone , Pediatrics , Low Cardiac Output
About this trial
This is an interventional treatment trial for Dobutamine, Milrinone , Pediatrics , Low Cardiac Output
Eligibility Criteria
Inclusion Criteria: 1-Patients from age of 1 month to 14 years old of both sexes. 2-Patients presenting with fluid refractory shock with low cardiac output state, evidenced by sustained hypotension (systolic blood pressure below 5th percentile for age) and end organ dysfunction (altered level of consciousness, renal or hepatic dysfunction) 3-Clinical evidence of systemic and/or pulmonary congestion despite use of vasodilators and/or diuretics 4-Refractory heart failure requiring admission for inotropic support. Exclusion Criteria: 1-All other causes of pediatric shock not in need for inotropic support (eg.isolated hypovolemic shock, anaphylaxis,….) 2 - patients not fit for randomization needing specific line of management (eg. Sever hypotension patients with good filling pressure unfit for milrinone , patients previously known having sever pulmonary hypertension not fit for dobutamine ,…) 3-post cardiac surgery patients with low cardiac output manifestation.
Sites / Locations
- Cairo University Children'S Hospital
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
patients who will recieve dobutrex
patients who will recieve milirinone
patient presenting with acute heart failure , who will recieve dobutrex as a result of their randomixation , startng dose will be 5 mic , assesing their need for tittration of dose , the need for addition of another inotrope , the prescence of any side effects and the duration of inotropic use for reaching hemodynamically stable state
patient presenting with acute heart failure , who will recieve milirinone as a result of their randomixation , startng dose will be 0.25 mic , assesing their need for tittration of dose , the need for addition of another inotrope , the prescence of any side effects and the duration of inotropic use for reaching hemodynamically stable state