SynthesisNeurosurgical review2021
Intravenous milrinone for treatment of delayed cerebral ischaemia following subarachnoid haemorrhage: a pooled systematic review.
Synthesis in Neurosurgical review, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Milrinone for the treatment of heart failure caused by severe Pneumonia in children with congenital heart disease: a meta-analysis.BMC pediatrics · 2023Pooled it
- The Effects of Milrinone Systemic Administration on Cerebral Perfusion as Measured with Computed Tomography in Aneurysmal Subarachnoid Hemorrhage Patients.Neurocritical care · 2026Observational
- Article
- A Comparison of Three Perfusion Algorithms in Patients at Risk of Delayed Cerebral Ischemia After Subarachnoid Hemorrhage.Diagnostics (Basel, Switzerland) · 2025Article
- Delayed cerebral ischaemia after subarachnoid haemorrhage: pathophysiology, diagnosis and neurotherapeutic opportunities.Discover medicine · 2025Article
- Evidence-Based Approach to Cerebral Vasospasm and Delayed Cerebral Ischemia: Milrinone as a Therapeutic Option-A Narrative Literature Review and Algorithm Treatment Proposition.Neurology international · 2025Review
- High-Grade Subarachnoid Hemorrhage - Beyond Guidelines.Neurologic clinics · 2025Review
- Clinical Evidence for Intravenous Milrinone to Treat Secondary Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage-A Narrative Review.Acta neurochirurgica. Supplement · 2025Review
- CT perfusion-guided administration of IV milrinone is associated with a reduction in delayed cerebral infarction after subarachnoid hemorrhage.Scientific reports · 2024Article
- Contemporary management of aneurysmal subarachnoid haemorrhage. An update for the intensivist.Intensive care medicine · 2024Review
- Pharmacotherapy in SAH: Clinical Trial Lessons.CNS & neurological disorders drug targets · 2024Review
- Treating Vasospasm with IV Milrinone: Relax (The Vessel) or Don't Do It!Neurocritical care · 2023Article
- Article
- Hemodynamic response and clinical outcome following intravenous milrinone plus norepinephrine-based hyperdynamic hypertensive therapy in patients suffering secondary cerebral ischemia after aneurysmal subarachnoid hemorrhage.Acta neurochirurgica · 2022Article
- Effect of inotropic agents on oxygenation and cerebral perfusion in acute brain injury.Frontiers in neurology · 2022Article
- Nimodipine vs. Milrinone - Equal or Complementary Use? A Retrospective Analysis.Frontiers in neurology · 2022Article
- Management of radiological cerebral vasospasm after coil embolization for ruptured intracranial aneurysms: A noninferiority bicentric cohort study.Brain circulationArticle
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Small trials have demonstrated promising results utilising intravenous milrinone for the treatment of delayed cerebral ischaemia (DCI) after subarachnoid haemorrhage (SAH). Here we summarise and contextualise the literature and discuss the future directions of intravenous milrinone for DCI. A systematic, pooled analysis of literature was performed in accordance with the PRISMA statement. Methodological rigour was analysed using the MINORS criteria. Extracted data included patient population; treatment protocol; and clinical, radiological, and functional outcome. The primary outcome was clinical resolution of DCI. Eight hundred eighteen patients from 10 single-centre, observational studies were identified. Half (n = 5) of the studies were prospective and all were at high risk of bias. Mean age was 52 years, and females (69%) outnumbered males. There was a similar proportion of low-grade (WFNS 1-2) (49.7%) and high-grade (WFNS 3-5) (50.3%) SAH. Intravenous milrinone was administered to 523/818 (63.9%) participants. Clinical resolution of DCI was achieved in 375/424 (88%), with similar rates demonstrated with intravenous (291/330, 88%) and combined intra-arterial-intravenous (84/94, 89%) therapy. Angiographic response was seen in 165/234 (71%) receiving intravenous milrinone. Hypotension (70/303, 23%) and hypokalaemia (31/287, 11%) were common drug effects. Four cases (0.5%) of drug intolerance occurred. Good functional outcome was achieved in 271/364 (74%) patients. Cerebral infarction attributable to DCI occurred in 47/250 (19%), with lower rates in asymptomatic spasm. Intravenous milrinone is a safe and feasible therapy for DCI. A signal for efficacy is demonstrated in small, low-quality trials. Future research should endeavour to establish the optimal protocol and dose, prior to a phase-3 study.
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Registered trials
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