Objective: To systematically review the efficacy of milrinoneon injection in the treatment of children with congenital heart disease (CHD) complicated with severe pneumonia and heart failure. Methods: PubMed

EMBase

the Cochrane Library

Wanfang database

CBM and CNKI were retrieved to collect the randomized controlled trials (RCT) of milrinoneon injection in the treatment of children with CHD complicated with severe pneumonia and heart failure (the control group was given conventional symptomatic treatment + dopamine injection or digitalis

while the experimental group received conventional symptomatic treatment + milrinone injection). The retrieval time was from the establishment of the database to Aug. 2018. Two reviewers independently selected the literature

extracted the data and evaluated the methodological quality

Meta-analysis was performed by using RevMann 5.3 software

and the quality of evidence was evaluated with the Jadad system. Results: A total of 5 RCT were enrolled

including 398 patients. Compared with the control group

the total effective rate (OR=1.25

95%CI from 1.13 to 1.37

P<0.01)

the stable time of heart rate (SMD=-1.28

95%CI from -1.65 to -0.91

P<0.01)

the stable time of respiratory or cough symptoms (SMD=-2.18

95%CI from -4.02 to -0.34

P<0.05) and the cardiac function index (LVEF) (SMD=1.14

95%CI from 0.66 to 1.62

P<0.01) had significant advantages in the experimental group. There was no significant difference in the incidence of adverse drug reactions between two groups (OR=1.31

95%CI from 0.57 to 3.03

P>0.05). Conclusion: Milrinone in the treatment of children with CHD complicated with severe pneumonia and heart failure may improve clinical symptoms and cardiac function more rapidly and increase the overall efficiency. However

due to limitations in the quality of the literature

evidence from double-blind randomized trials with large samples is still neede