Home Milrinone Therapy for Paediatric Advanced Heart Failure Patients: A Canadian Single-Centre Experience
Bibliographic record
Abstract
Background: End-stage heart failure (ESHF) is the primary reason for heart transplantation in children with cardiomyopathy. Despite optimizing oral heart failure (HF) medications, some paediatric patients progress to ESHF, necessitating mechanical circulatory support and/or transplantation. Continuous milrinone intravenous support has been used to bridge paediatric patients to transplant. This study aimed to review and report the safety and outcomes of our home milrinone therapy (HMT) programme. Methods: This single-centre, retrospective cohort study included paediatric patients discharged on HMT between 2001 and 2022. Data were collected from the SickKids HF Database. Outcomes of interest included frequency and indications for rehospitalization, catheter-related complications, and outcomes at the conclusion of therapy. Results: Thirty-six patients were included, with a median age of 3.6 years and a median weight of 13.1 kg at HMT initiation. HMT was used as a bridge to transplantation (58%) recovery/candidacy (22%), palliative care (17%), and surgical repair (3%). The median duration on HMT was 88 days. Twenty-four patients (67%) were readmitted at least once with a total of 70 admissions, primarily due to central line-related issues (35%) and worsening HF (32%). Among patients discharged as a bridge to transplant, 52% were admitted from home for transplant, whereas 33% required readmission until transplant. No deaths were directly related to HMT. Conclusions: HMT is a safe and effective method for supporting children with ESHF. This therapy allows children to return to their home environment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".