title: First experiences with intraoperative Levosimendan in pediatric cardiac surgery.
abstract: Levosimendan is a calcium-sensitizing agent with effective inotropic properties. It has been shown to improve cardiac function, hemodynamic performance, and survival in adults with severe heart failure. However, the effect of Levosimendan in pediatric cardiac surgery has not yet been investigated. Thus, we report on our experience with the intraoperative application of Levosimendan in seven infants (body weight range 2.6-6.3 kg) with severe myocardial dysfunction after complex congenital heart surgery. During the administration of Levosimendan, the heart rate, mean arterial blood pressure, and central venous pressure did not change. The mean arterial lactate level significantly decreased 24 and 48 h after the first infusion compared to baseline. Central venous oxygen saturation increased significantly 24 and 48 h after the onset of Levosimendan infusion. We found intraoperatively administered Levosimendan to be well tolerated in the seven infants with severe myocardial dysfunction after complex congenital heart surgery. Levosimendan is a new rescue drug which has beneficial effects, even in pediatric cardiac surgery.
authors.affiliation: Klinik für Anästhesiologie und Intensivmedizin, OE 8050, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. Osthaus.Alexander@MH-Hannover.de
authors.forename: Wilhelm Alexander
authors.initials: WA
authors.lastname: Osthaus
authors.forename: Dietmar
authors.initials: D
authors.lastname: Boethig
authors.forename: Michael
authors.initials: M
authors.lastname: Winterhalter
authors.forename: Dirk
authors.initials: D
authors.lastname: Huber
authors.forename: Heidi
authors.initials: H
authors.lastname: Goerler
authors.forename: Michael
authors.initials: M
authors.lastname: Sasse
authors.forename: Robert
authors.initials: R
authors.lastname: Sümpelmann
mesh_terms: D002302:Cardiac Output / Q000187:drug effects; D002303:Cardiac Output, Low / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006321:Heart / Q000187:drug effects*; D006330:Heart Defects, Congenital / Q000601:surgery*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006835:Hydrazones / Q000008:administration & dosage / Q000627:therapeutic use*; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D007432:Intraoperative Period; D019344:Lactic Acid / Q000097:blood; D007902:Length of Stay; D010100:Oxygen / Q000097:blood; D011183:Postoperative Complications / Q000188:drug therapy; D011724:Pyridazines / Q000008:administration & dosage / Q000627:therapeutic use*; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D000077464:Simendan; D014188:Transposition of Great Vessels / Q000601:surgery
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D019344:Lactic Acid; D000077464:Simendan; D010100:Oxygen