Ambulatory Intravenous Inotropic Support and or Levosimendan in Pediatric and Congenital Heart Failure: Safety, Survival, Improvement, or Transplantation

Pediatric Cardiology
Sotiria C ApostolopoulouSpyridon Rammos

Abstract

End-stage heart failure (HF) frequently needs continuous inotropic support in hospital and has high morbidity and mortality in absence of heart transplantation. This study reports outcome, efficacy, and safety of continuous ambulatory inotropes (AI) and/or periodic levosimendan (LS) infusions in pediatric HF patients. The study included 27 patients, median age 9.4 (0.1-26.1) years, with severe HF (6 myocarditis, 13 dilated cardiomyopathy, 2 restrictive cardiomyopathy, 6 repaired congenital heart disease). Dobutamine and milrinone AI were administered in 21 patients through a permanent central catheter for median duration 1.0 (0.3-3.7) years. Additionally, 14 AI patients and the remaining 6 study patients received periodic LS infusions for median duration 1.1 (0.2-4.2) years. During median follow-up 2.1 (0.3-21.3) years, 4 patients died of worsening HF after 0.8-2.1 years AI, 6 patients underwent heart transplantation with only 3 survivors, while the rest remained stable out of the hospital with complications 4 line infections treated with antibiotics and 4 catheter reinsertions due to dislodgement. Severe pulmonary hypertension was reversed with AI in 2 patients, allowing successful heart-only transplantation. Therapy with AI w...Continue Reading

References

Feb 1, 2005·Cardiology in the Young·Robert F EnglishSteven A Webber
May 10, 2006·European Heart Journal·Leonardo De LucaMihai Gheorghiade
Apr 24, 2007·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Edward K RheeDavid C Naftel
Apr 24, 2007·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Alexandria M BergWilliam T Mahle
Jun 29, 2007·Clinical Pharmacokinetics·Saila AntilaLasse A Lehtonen
Sep 13, 2007·JAMA : the Journal of the American Medical Association·Robert E ShaddyUNKNOWN Pediatric Carvedilol Study Group
Oct 8, 2009·Circulation. Heart Failure·Eiran Z GorodeskiRandall C Starling
Jan 28, 2012·Circulation. Heart Failure·Soon J ParkUNKNOWN HeartMate II Clinical Investigators
May 25, 2013·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·James K Kirklin
Jul 9, 2013·Interactive Cardiovascular and Thoracic Surgery·Ullas AngadiMohammed F Chowdhry
Dec 5, 2014·Circulation. Heart Failure·Brian F BirnbaumCharles E Canter
Jan 22, 2015·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Fabrizio De RitaMassimo Griselli
Nov 29, 2015·Archives of Disease in Childhood·Trisha V VigneswaranMichael Burch
Dec 30, 2016·World Journal for Pediatric & Congenital Heart Surgery·Pertti SuominenOtto Rahkonen
Aug 7, 2017·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Joseph W RossanoUNKNOWN International Society for Heart and Lung Transplantation

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Cardiac Remodeling

Cardiac remodeling in response to a myocardial infarction is characterized by progressive ventricular dilatation, cardiac hypertrophy, fibrosis, and deterioration of cardiac performance. Discover the latest research on Cardiac Remodeling here.

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Birth Defects

Birth defects encompass structural and functional alterations that occur during embryonic or fetal development and are present since birth. The cause may be genetic, environmental or unknown and can result in physical and/or mental impairment. Here is the latest research on birth defects.

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.