Observational studyTherapeutic drug monitoring2018
Acute Kidney Injury Biomarkers Predict an Increase in Serum Milrinone Concentration Earlier Than Serum Creatinine-Defined Acute Kidney Injury in Infants After Cardiac Surgery.
Observational study in Therapeutic drug monitoring, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Biomarkers of acute kidney injury after pediatric cardiac surgery: a meta-analysis of diagnostic test accuracy.European journal of pediatrics · 2022Pooled it
- Dexmedetomidine and acute kidney injury following cardiac surgery in pediatric patients-An updated systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2022Pooled it
- Developmental Pharmacokinetics and Age-Appropriate Dosing Design of Milrinone in Neonates and Infants with Acute Kidney Injury Following Cardiac Surgery.Clinical pharmacokinetics · 2019Trial
- Biomarkers in neonatal kidney disease: proceedings from the first international neonatal nephrology symposium.Pediatric research · 2026Article
- Urine NGAL adds to serum creatinine in predicting cefepime clearance in critically ill children at high risk of acute kidney injury.International journal of antimicrobial agents · 2026Article
- Urinary Biomarkers and Attainment of Cefepime Therapeutic Targets in Critically Ill Children.The Pediatric infectious disease journal · 2025Observational
- Evaluation of uNGAL and TIMP-2*IGFBP7 as early biomarkers of Acute Kidney Injury in Caucasian term and preterm neonates: a prospective observational cohort study.Italian journal of pediatrics · 2025Observational
- High-intensity interval training attenuates renal injury induced by myocardial ischemia-reperfusion in rats.Journal of the Chinese Medical Association : JCMA · 2025Article
- Pharmacokinetics in Critically Ill Children with Acute Kidney Injury.Paediatric drugs · 2023Review
- Association of Urine Biomarkers With Acute Kidney Injury and Fluid Overload in Infants After Cardiac Surgery: A Single Center Ancillary Cohort of the Steroids to Reduce Systemic Inflammation After Infant Heart Surgery Trial.Critical care explorations · 2023Article
- β-lactam precision dosing in critically ill children: Current state and knowledge gaps.Frontiers in pharmacology · 2022Review
- Association between Elevated Urine Neutrophil Gelatinase-Associated Lipocalin and Postoperative Acute Kidney Injury in Neonates.The Journal of pediatrics · 2021Observational
- Hemodynamic response to milrinone for refractory hypoxemia during therapeutic hypothermia for neonatal hypoxic ischemic encephalopathy.Journal of perinatology : official journal of the California Perinatal Association · 2021Article
- Circulating cyclic adenosine monophosphate concentrations in milrinone treated paediatric patients after congenital heart surgery.Cardiology in the young · 2021Observational
- Pediatric acute kidney injury: new advances in the last decade.Kidney research and clinical practice · 2021Article
- The effectiveness of urinary TIMP-2 and IGFBP-7 in predicting acute kidney injury in critically ill neonates.Pediatric research · 2020Article
- Early prediction of acute kidney injury in neonates with cardiac surgery.World journal of pediatric surgery · 2020Review
Corrections and comments
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Authors and funding
15 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundMilrinone, an inotropic agent used ubiquitously in children after cardiac surgery, accumulates in acute kidney injury (AKI). We assessed if urinary AKI biomarkers are predictive of an increase in milrinone concentrations in infants after cardiac surgery.
methodsMulticenter prospective pilot study of infants undergoing cardiac surgery. Urinary AKI biomarkers were measured in the urine at specific time intervals after cardiopulmonary bypass initiation. AKI was defined using the Kidney Disease: Improving Global Outcomes serum creatinine criteria. Serum milrinone concentrations were measured at specific intervals after drug initiation, dose changes, and termination. Excessive milrinone activity was defined as a 20% increase in serum concentration between 6 and 36 hours after initiation. The temporal relationship between urinary AKI biomarker concentrations and a 20% increase in milrinone concentration was assessed.
resultsAKI occurred in 31 (33%) of infants. Milrinone clearance was lower in patients with AKI (4.2 versus 5.6 L/h/70 kg; P = 0.02). Excessive milrinone activity was associated with development of serum creatinine-defined AKI [odds ratio (OR) 3.0; 95% confidence interval (CI), 1.21-7.39; P = 0.02]. Both tissue inhibitor metalloproteinase type 2 and insulin-like growth factor-binding protein type 7 (TIMP-2*IGFBP-7) ≥0.78 at 12 hours (OR 2.72; 95% CI, 1.01-7.38; P = 0.04) and kidney injury molecule 1 (KIM-1) ≥529.57 at 24 hours (OR 2.76; 95% CI, 1.06-7.17; P = 0.04) predicted excessive milrinone activity before a diagnosis of AKI.
conclusionsIn this pilot study, urine TIMP-2*IGFBP-7 and KIM-1 were predictive of AKI and excessive milrinone activity. Future studies that include a pharmacodynamics assessment of patient hemodynamics, excessive milrinone activity, and AKI biomarker concentrations may be warranted to integrate this concept into clinical practice.
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