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Levosimendan for low cardiac output: a pediatric experience
Jonathan R Egan1, Andrew J B Clarke, Stephen Williams
1Pediatric Intensive Care Unit, Children's Hospital at Westmead, Sydney, Australia.
Journal of Intensive Care Medicine
|May 5, 2006
Summary
Levosimendan was safely administered to pediatric patients with low cardiac output, showing improved hemodynamics and tissue perfusion. This study suggests levosimendan warrants further evaluation as an inotrope in pediatric critical care.
Area of Science:
- Pediatric Intensive Care Medicine
- Cardiology
- Pharmacology
Background:
- Low cardiac output syndrome is a critical condition in pediatric patients.
- Conventional inotropes have limitations and potential adverse effects.
- Levosimendan is a calcium sensitizer with vasodilatory properties.
Purpose of the Study:
- To evaluate the safety and efficacy of levosimendan in pediatric patients with low cardiac output.
- To assess the hemodynamic effects and tissue perfusion changes following levosimendan administration.
- To explore the potential of levosimendan as an alternative inotropic agent in pediatrics.
Main Methods:
- Retrospective observational study of 19 pediatric patients in a intensive care unit.
- Levosimendan administration during or after cardiopulmonary bypass.
- Monitoring of hemodynamic parameters, arterial lactate levels, and inotropic agent use.
Main Results:
- No adverse events or clinical worsening attributed to levosimendan.
- Significant decrease in arterial lactate levels during cardiopulmonary bypass.
- Trends toward improved hemodynamics including heart rate reduction, increased mean blood pressure, and reduced conventional inotrope use.
Conclusions:
- Levosimendan was safely used in a small cohort of pediatric patients with low cardiac output.
- Levosimendan demonstrated potential for improving hemodynamics and tissue perfusion.
- Further evaluation of levosimendan as an inotropic agent in the pediatric population is warranted.
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