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.
Associated Clinical Trials
Levosimendan, a novel Ca2+ sensitizer, activates the glibenclamide-sensitive K+ channel in rat arterial myocytes
Acute hemodynamic and clinical effects of levosimendan in patients with severe heart failure. Study Investigators
Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low-output heart failure (the LIDO study): a randomised double-blind trial
Safety and efficacy of a novel calcium sensitizer, levosimendan, in patients with left ventricular failure due to an acute myocardial infarction. A randomized, placebo-controlled, double-blind study (RUSSLAN)
Efficacy and safety of milrinone in preventing low cardiac output syndrome in infants and children after corrective surgery for congenital heart disease
Levosimendan for bridging in a pediatric patient with Alström syndrome awaiting heart-lung transplantation
Age-dependent effects of milrinone and levosimendan on ventricular function and haemodynamics in newborn and mature pigs
Milrinone is preferred to levosimendan for mesenteric perfusion in hypoxia-reoxygenated newborn piglets treated with dopamine
Levosimendan versus milrinone in neonates and infants after corrective open-heart surgery: a pilot study
Part 10: Pediatric basic and advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations
Single-center experience with levosimendan in children undergoing cardiac surgery and in children with decompensated heart failure
Pediatric basic and advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations
Clinical practice: heart failure in children. Part I: clinical evaluation, diagnostic testing, and initial medical management
Part 10: Paediatric basic and advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations
Initial Observations of the Effects of Calcium Chloride Infusions in Pediatric Patients with Low Cardiac Output
Inotropic support in the NICU: ever more compounds in search of guidance? Commentary on J. Esch et al.: differential hemodynamic effects of levosimendan in a porcine model of neonatal hypoxia-reoxygenation (Neonatology 2012;101:192–200) and M.P. De Carolis et al.: levosimendan in two neonates with ischemic heart failure and pulmonary hypertension (Neonatology 2012;101:201–205)
Differential hemodynamic effects of levosimendan in a porcine model of neonatal hypoxia-reoxygenation
Prophylactic levosimendan for the prevention of low cardiac output syndrome and mortality in paediatric patients undergoing surgery for congenital heart disease
Question 2 Is levosimendan better than milrinone in preventing post operative low cardiac output syndrome and improving cardiac function in children with congenital heart disease?
Cardiopulmonary Resuscitation in Infants and Children With Cardiac Disease: A Scientific Statement From the American Heart Association
The Perspective of the Intensivist on Inotropes and Postoperative Care Following Pediatric Heart Surgery: An International Survey and Systematic Review of the Literature
Use of Levosimendan in Postoperative Setting After Surgical Repair of Congenital Heart Disease in Children
Effect of Preoperative Infusion of Levosimendan on Biomarkers of Myocardial Injury and Haemodynamics After Paediatric Cardiac Surgery: A Randomised Controlled Trial.
Current and Future Drug and Device Therapies for Pediatric Heart Failure Patients: Potential Lessons from Adult Trials.
Clinical efficacy of levosimendan vs milrinone in preventing low cardiac output syndrome following pediatric cardiac surgery.
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.