在动脉切换手术后,Levosimendan与Milrinone的比较,用于≤3公斤的婴儿
Reena Khantwal Joshi1, Raja Joshi2, Neeraj Aggarwal3
1Division of Pediatric Cardiac Anesthesia, Sir Ganga Ram Hospital, New Delhi, India.
概括
利沃西门丹是一种安全有效的替代品milrinone治疗低心输出综合征在动脉切换手术后新生儿,显示的保护性益处.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 心血管外科心血管外科
- 新生儿重症监护中心
背景情况:
- 低心输出综合征 (LCOS) 是新生儿的动脉开关手术 (ASO) 后的一个关键并发症.
- 异构剂和异构扩散剂用于管理LCOS,但levosimendan的作用仍然不那么明确.
- 这项研究调查了levosimendan与milrinone对于LCOS后ASO.
研究的目的:
- 为了比较levosimendan和milrinone在新生儿中的疗效和安全性,与ASO后的LCOS.
- 评估这些药物对心脏指数,乳酸清除和功能的影响.
- 评估与每种治疗相关的医院死亡率.
主要方法:
- 在2017年1月至2022年1月接受ASO的新生儿 (3kg以下) 的回顾性比较研究.
- 患者接受了levosimendan或milrinone作为LCOS的主要治疗.
- 分析了心声学,血液动力学和生物化学参数.
主要成果:
- 在术后的第一天和第二天,Levosimendan组的低心脏指数发病率较低 (9.3%对26.2%,P=.04).
- 莱沃西门丹与较早的乳酸清除和更好的中央静脉氧和有关.
- 在米利诺组中观察到急性损伤 (AKI) 的更高患病率 (50% vs 28%,P=.03),需要腹腔透析的增加.
结论:
- 利沃西门丹是一种安全有效的替代品milrinone管理LCOS在新生儿后ASO.
- 与milrinone相比,levosimendan显示出对的保护作用.
- 两组之间没有观察到医院死亡率的显著差异.
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