Single-center experience with levosimendan in children undergoing cardiac surgery and in children with decompensated heart failureReport as inadecuate




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BMC Anesthesiology

, 11:18

First Online: 05 October 2011Received: 16 May 2011Accepted: 05 October 2011

Abstract

BackgroundLevosimendan has pharmacologic and hemodynamic advantages over conventional intravenous inotropic agents. It has been used mainly as a rescue drug in the pediatric intensive care unit or in the operating room. We present the largest single-center experience of levosimendan in children.

MethodsRetrospective analysis of all children who received levosimendan infusions between July 5, 2001 and July 4, 2010 in a pediatric intensive care unit. The results of a questionnaire for physicians anesthesiologist-intensivists, cardiologists and cardiac surgeons concerning their clinical perceptions of levosimendan are evaluated

ResultsDuring the study period a total of 484 infusions were delivered to 293 patients 53% of whom were male. The median age of the patients was 0.4 years 4 hours-21.1 years at the time of levosimendan administration. A majority of levosimendan infusions were administered to children who were undergoing cardiac surgery 72%, 14% to children with cardiomyopathy and 14% to children with cardiac failure. Eighty-nine out of the 293 patients 30.4% received repeated doses of levosimendan up to 11 infusions. The most common indication for the use of levosimendan 94% was when the other inotropic agents were insufficient to maintain stable hemodynamics. Levosimendan was especially used in children with cardiomyopathy 100% or with low cardiac output syndrome 94%. A majority 89% of the respondents believed that levosimendan administration postponed the need for mechanical assist devices in some children with cardiomyopathy. Moreover, 44% of respondents thought that the mechanical support was totally avoided in some patients undergoing cardiac surgery after receiving levosimendan.

ConclusionLevosimendan is widely used in our institution and many physicians believe that its use could decrease the need for mechanical support in children undergoing cardiac surgery or in children with decompensated heart failure. However, there is a lack of good empirical evidence in children to support this perception.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2253-11-18 contains supplementary material, which is available to authorized users.

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Author: Pertti K Suominen

Source: https://link.springer.com/







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