The Perspective of the Intensivist on Inotropes and Postoperative Care Following Pediatric Heart Surgery: An International Survey and Systematic Review of the Literature

World Journal for Pediatric & Congenital Heart Surgery
Peter P Roeleveld, J C A de Klerk

Abstract

Inotropes are frequently being used in children undergoing heart surgery to prevent or treat low cardiac output syndrome (LCOS). There is only limited evidence that inotropes actually positively influence postoperative outcome. Our aim was to describe the current international practice variation in the use of inotropes following congenital heart surgery. We developed an online survey regarding the postoperative use of inotropes. We sent an invitation to all 197 registered members of the Pediatric Cardiac Intensive Care Society (PCICS) to participate in the survey. We also performed a systematic review of the literature. Ninety-eight people (50%) responded, representing 62 international centers. Milrinone is routinely used perioperatively by 90 respondents (97%). Adrenaline/epinephrine is routinely used by 43%, dopamine by 36%, dobutamine by 11%, and levosimendan by 6%. Steroids are used routinely by 54% before initiating cardiopulmonary bypass. Vasopressin is used by 44% of respondents. The development of LCOS is monitored with lactate in 99% of respondents, physical examination (98%), intermittent mixed venous saturation (76%), continuous mixed venous saturation (13%), echocardiography (53%), core-peripheral temperature gap (2...Continue Reading

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Citations

Apr 16, 2020·World Journal for Pediatric & Congenital Heart Surgery·Elizabeth H StephensEric L Wald
Jun 24, 2020·JAMA : the Journal of the American Medical Association·Vladimir LomivorotovDmitry Ponomarev
Jun 28, 2018·World Journal for Pediatric & Congenital Heart Surgery·Peter Paul Roeleveld
Jun 28, 2018·World Journal for Pediatric & Congenital Heart Surgery·Jon Kaufman, Eduardo M da Cruz
Mar 29, 2020·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·M Girona-AlarcónM Balaguer
Feb 9, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Viviane G Nasr, Kevin Friedman
Jul 12, 2020·The Annals of Thoracic Surgery·George M HoffmanJames S Tweddell
May 24, 2021·Journal of Cardiothoracic and Vascular Anesthesia·John Richard McNamaraMichael Griffin
Oct 9, 2021·Brazilian Journal of Anesthesiology·Shan Gao, Youjing Dong

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Methods Mentioned

BETA
coronary artery bypass

Clinical Trials Mentioned

NCT00549107
NCT01576094
NCT00695929

Software Mentioned

Primacorp

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