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Outpatient continuous parenteral inotropic therapy as bridge to transplantation in children with advanced heart

Jack F Price1, Jeffrey A Towbin, William J Dreyer

  • 1Department of Pediatrics, Lillie Frank Abercrombie Section of Pediatric Cardiology, Baylor College of Medicine; Texas Children's Hospital, 6621 Fannin, MC 19345-C, Houston, TX 77030, USA.

Journal of Cardiac Failure
|March 8, 2006
PubMed

Insights

Outpatient parenteral inotropic therapy (PIT) can reduce hospitalizations and emergency visits for children with advanced heart failure. This therapy may successfully bridge selected pediatric patients to cardiac transplantation.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Research
  • Medical Therapy

Background:

  • Advanced heart failure in children presents significant morbidity and mortality.
  • Standard medical therapies are often ineffective for pediatric advanced chronic heart failure.

Purpose of the Study:

  • To review the institutional experience with outpatient parenteral inotropic therapy (PIT).
  • To evaluate the efficacy of PIT for advanced chronic heart failure in pediatric patients.

Main Methods:

  • Retrospective review of medical records for pediatric patients treated with outpatient PIT.
  • Analysis of patient demographics, duration of therapy, emergency department visits, hospital admissions, and ejection fraction (EF%).

Main Results:

  • Seven pediatric patients received outpatient PIT (mean age 14.6 years).
  • PIT significantly reduced emergency department visits and hospital admissions for heart failure exacerbations.
  • Mean EF% improved in patients with systolic dysfunction on PIT.
  • Six out of seven patients were successfully bridged to cardiac transplantation.

Conclusions:

  • Outpatient continuous parenteral inotropic therapy (PIT) is a viable treatment option for selected pediatric patients.
  • PIT can serve as a successful bridge to cardiac transplantation in pediatric heart failure management.
Abstract

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