Key result
Pharmacologic therapies for pediatric post-surgical LCOS require tailoring to each patient's specific physiologic derangements.
Why the study?
Low cardiac output syndrome following pediatric cardiac surgery requiring cardiopulmonary bypass causes significant morbidity and mortality if unrecognized or untreated.
Management of low cardiac output syndrome in children after cardiac surgery requires tailoring pharmacologic therapies to individual physiologic derangements due to heterogeneous etiologies and significant practice variation.
Answers are grounded in this paper and cite their sources.
Supports individualized pharmacologic selection in pediatric post-cardiac surgery LCOS; leaves open prospective trials to reduce practice variation.
The low cardiac output syndrome describes the phenomenon of the reduction of cardiac output that can occur following cardiac surgery requiring cardiopulmonary bypass. If unrecognized or untreated, this condition can result in significant morbidity and mortality. Along with non-pharmacologic therapies, pharmacologic agents used to help manage the low cardiac output syndrome include catecholamine inotropes, inodilators, systemic vasodilators, pulmonary vasodilators, and other classes of medications. We summarize the rationale and key evidence supporting the use of these therapies in children. In addition, utilizing provider surveys and registry reviews, we describe the current trends in the use of these medications and the variation demonstrated between providers and centers. Given the heterogeneous etiology of low cardiac output syndrome, successful management requires that pharmacologic therapies be tailored to the physiologic derangements of each patient.
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Sahulee et al. (2022) conducted a review in Low cardiac output syndrome in children after cardiac surgery. Pharmacologic therapies (catecholamine inotropes, inodilators, systemic and pulmonary vasodilators) was evaluated. Pharmacologic therapies for low cardiac output syndrome in children after cardiac surgery must be tailored to the physiologic derangements of each patient due to the condition's heterogeneous etiology.
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