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Levosimendan for Low Cardiac Output: A Pediatric Experience

Pediatric Intensive Care Unit, the Children’s Hospital at Westmead, Sydney, Australia

Andrew J. B. Clarke, MBBS, FRACS

Adolph Basser Cardiac Institute, the Children’s Hospital at Westmead, Sydney, Australia

Stephen Williams, MBBS, MRCP(UK), MRCPCH

Pediatric Intensive Care Unit, the Children’s Hospital at Westmead, Sydney, Australia

Andrew D. Cole, BAppSc(Hons)

Julian Ayer, MBBS

Adolph Basser Cardiac Institute, the Children’s Hospital at Westmead, Sydney, Australia

Stephen Jacobe, MBBS, BMed, FRACP, FJFICM

Pediatric Intensive Care Unit, the Children’s Hospital at Westmead, Sydney, Australia

Richard B. Chard, MBBS, BDS, FRACS

Adolph Basser Cardiac Institute, the Children’s Hospital at Westmead, Sydney, Australia

David S. Winlaw, MBBS(Hons), MD, FRACS

Adolph Basser Cardiac Institute, the Children’s Hospital at Westmead, Sydney, Australia, davidw{at}chw.edu.au

This was a retrospective observational study in a pediatric intensive care unit, in which 19 patients received levosimendan. There were no adverse events attributable to levosimendan and no instances where the clinical condition worsened after administration. Arterial lactate levels decreased significantly following levosimendan administration during cardiopulmonary bypass for anticipated low cardiac output. In those with established low cardiac output, trends toward improved hemodynamics were seen, with heart rate reduction, an increase in mean blood pressure, a reduction in arterial lactate, and reduced conventional inotrope use. Levosimendan was safely used in a small number of pediatric patients with established low cardiac output state who demonstrated improved hemodynamics and tissue perfusion, with a tendency to reduced conventional inotrope usage, and this warrants its evaluation as an inotrope in the pediatric population.

Key Words: levosimendan • congenital heart disease • heart failure • pediatric

Journal of Intensive Care Medicine, Vol. 21, No. 3, 183-187 (2006)
DOI: 10.1177/0885066606287039


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