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Digitalis use in children: an uncertain future

Hougen1

  • 1Georgetown University Children's Medical Center, Division of Cardiology, 2-PHC, 3800 Reservoir Road NW, 20007-2197, Washington, DC, USA

Progress in Pediatric Cardiology
|December 15, 2000
PubMed

Insights

Digoxin use for pediatric large left-to-right shunts is declining. While it aids understanding of cardiac glycosides, improved surgical and medical options offer better outcomes with less toxicity.

Area of Science:

  • Pediatric Cardiology
  • Pharmacology
  • Cardiac Physiology

Background:

  • Therapeutic indications for digoxin in children with large left-to-right shunts are under review.
  • Hemodynamic burden in these conditions reveals preserved systolic performance.

Purpose of the Study:

  • To summarize studies on cardiac glycoside use in pediatric large left-to-right shunts.
  • To discuss the diminishing clinical utility of digoxin in this patient population.

Main Methods:

  • Review of existing studies on digoxin and cardiac glycosides.
  • Analysis of pharmacological interventions and surgical treatments for pediatric shunts.

Main Results:

  • Pharmacological interventions like afterload reduction show promise with low toxicity.
  • Early surgical intervention for pulmonary overcirculation reduces medical management duration and complications.
  • Understanding of cation transport is enhanced by cardiac glycosides, but clinical utility has decreased.

Conclusions:

  • Digoxin's role in treating pediatric large left-to-right shunts is diminishing.
  • Newer therapeutic agents and surgical approaches offer improved outcomes.
  • Cardiac glycosides have contributed to understanding molecular mechanisms but are less clinically relevant now.

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