Why the study?
Does levosimendan improve hemodynamics and tissue perfusion in pediatric patients with low cardiac output?
Does levosimendan improve hemodynamics and tissue perfusion in pediatric patients with low cardiac output?
Levosimendan appears safe and may improve hemodynamics and tissue perfusion in pediatric patients with low cardiac output, warranting further evaluation.
Does not support routine use in pediatric low cardiac output; hypothesis-generating pending randomized trials.
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.
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Egan et al. (2006) studied this question.
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