RESEARCH ARTICLE


The Use of Milrinone Versus Conventional Treatment for the Management of Life-Threatening Bronchial Asthma



Amr Sobhy*, Doaa M. K. Eldin, Hany V. Zaki
Department of Anesthesia, Ain Shams University, Cairo, Egypt


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Creative Commons License
© 2019 Sobhy et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Anesthesia, Ain Shams University, Cairo, Egypt; Tel: 002010694383;
Email: dr.amrsobhy2013@gmail.com


Abstract

Background and Aims:

In our study, we investigated the effectiveness of intravenous milrinone in life-threatening bronchial asthma as compared to conventional treatment.

Methods:

Fifty patients aged 18-50 years, presenting with life-threatening asthma were enrolled in a Randomised Controlled Trial (RCT). They were randomly allocated into Group C (25 patients): who received the standard pharmacotherapy and placebo, and Group M (25 patients): who in addition to the standard therapy, received 25 μg milrinone as an initial slow IV bolus diluted in 10 ml of normal saline. The following data were recorded: PEFR (Peak Expiratory Flow Rate) expressed as a percentage of the patient’s previous value, Respiratory Rate (RR), MABP (Mean Arterial Blood Pressure), arterial blood gases, and the number of patients requiring mechanical ventilation. Differences between groups were tested using Analysis of Variance (ANOVA) for quantitative variables with post hoc using the Least Significant Difference (LSD) test, and Chi square test for categorical variables.

Results:

Group M showed marked improvement in PEFR that was highly significant (P < 0.001) 10 min after injection and significant after one hour from the start of treatment in comparison to Group C. There was also an improvement in RR and PO2 that was significant in group M. Milrinone was associated with a reduction in MABP only after 10 min from injection, and showed a statistically significant decrease in the number of patients requiring mechanical ventilator support (P ˂ 0.05).

Conclusion:

Milronine is a promising agent as a rescue drug in the treatment of life-threatening bronchial asthma.

Keywords: Milrinone, Status asthmatics, Phosphodiesterase 3 inhibitors, Bronchial asthma, Randomised controlled trial, Airways.