INTRODUCTION Milrinone is administered after patent ductus arteriosus (PDA) ligation to prevent and treat postoperative hemodynamic instability (i.e., postligation cardiac syndrome). We aimed to explore the effectiveness of milrinone on in-hospital outcomes in infants who underwent PDA ligation using a nationwide inpatient database in Japan. METHODS Using the Japanese Diagnosis Procedure Combination database, we identified patients who received milrinone after PDA ligation (n = 428) in neonatal intensive care units between July 2010 and March 2021 and those who did not (n = 3,392). We conducted a 1:4 propensity score-matched analysis with adjustment for background characteristics (e.g., gestational age, birth weight, comorbidities, preoperative treatments, and hospital background) to compare morbidities (bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, and retinopathy of prematurity), mortality, total hospitalization costs, and other outcomes. For sensitivity analysis, we performed an overlap propensity score-weighted analysis. RESULTS In-hospital morbidity, bronchopulmonary dysplasia, intraventricular hemorrhage, and necrotizing enterocolitis occurred in 58%, 48%, 9.5%, and 7.1% of patients, respectively; the in-hospital mortality was 5.4%. After 1:4 propensity score matching, no significant difference was observed regarding mortality (7.1 vs. 5.7%), in-hospital morbidity (55 vs. 50%), bronchopulmonary dysplasia (44 vs. 41%), intraventricular hemorrhage (7.8 vs. 9.1%), necrotizing enterocolitis (8.5 vs. 8.9%), retinopathy of prematurity (21 vs. 22%), or total hospitalization costs (median: approximately 86,000 vs. 82,000 US dollars) between milrinone users (n = 425) and nonusers (n = 1,698). Sensitivity analyses yielded consistent results. CONCLUSIONS Milrinone use after PDA ligation was not associated with improved in-hospital outcomes, such as mortality and morbidity.

中文翻译：

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米力农对动脉导管未闭结扎后新生儿的影响：全国数据库回顾性研究。

简介 米力农在动脉导管未闭（PDA）结扎后给药，以预防和治疗术后血流动力学不稳定（即结扎后心脏综合征）。我们旨在利用日本全国住院患者数据库探讨米力农对接受 PDA 结扎的婴儿住院结果的有效性。方法 使用日本诊断程序组合数据库，我们确定了 2010 年 7 月至 2021 年 3 月期间在新生儿重症监护病房接受 PDA 结扎后接受米力农治疗的患者 (n = 428) 和未接受治疗的患者 (n = 3,392)。我们进行了 1:4 倾向评分匹配分析，并调整了背景特征（例如胎龄、出生体重、合并症、术前治疗和医院背景​​），以比较患者的发病情况（支气管肺发育不良、脑室内出血、坏死性小肠结肠炎和视网膜病变）。早产）、死亡率、总住院费用和其他结果。对于敏感性分析，我们进行了重叠倾向得分加权分析。结果 院内发病率、支气管肺发育不良、脑室内出血和坏死性小肠结肠炎的发生率分别为 58%、48%、9.5% 和 7.1%；院内死亡率为5.4%。经过 1:4 倾向评分匹配后，在死亡率（7.1% vs. 5.7%）、住院发病率（55% vs. 50%）、支气管肺发育不良（44% vs. 41%）、脑室内出血（7.8% vs. 41%）方面没有观察到显着差异。米力农使用者 (n = 425) 和 9.1%)、坏死性小肠结肠炎 (8.5% vs. 8.9%)、早产儿视网膜病变 (21% vs. 22%) 或总住院费用（中位数：约 86,000 美元 vs. 82,000 美元）非用户 (n = 1,698)。敏感性分析得出了一致的结果。结论 PDA 结扎后使用米力农与死亡率和发病率等院内结局的改善无关。