title: Levosimendan in congenital cardiac surgery: a randomized, double-blind clinical trial.
abstract: OBJECTIVE
  In this study, the authors used a continuous infusion of either levosimendan or milrinone as inotropic support after corrective congenital cardiac surgery. The hemodynamic and biochemical parameters were compared.
  
  
  METHODS
  A prospective, randomized, double-blind clinical study.
  
  
  METHODS
  A university hospital.
  
  
  METHODS
  Forty-one patients between 0 and 5 years old requiring inotropic support for corrective congenital heart surgery under cardiopulmonary bypass (CPB) were enrolled in this trial. Thirty-six patients completed the study.
  
  
  METHODS
  Patients were randomized in a double-blind fashion to a continuous infusion of either levosimendan at 0.05 μg/kg/min or milrinone at 0.4 μg/kg/min started at the onset of CPB. Epinephrine was started at 0.02 μg/kg/min after aortic cross-clamp release in both groups.
  
  
  RESULTS
  There was no significant difference between serum lactate levels of groups. The rate-pressure index (the product of heart rate and systolic blood pressure), which is an indicator of myocardial oxygen demand, was significantly lower at 24 hours and 48 hours postoperatively in the levosimendan group (p < 0.001) in comparison to the milrinone group. Although not significantly different, the troponin values in the levosimendan group were less at 1 hour (median [P(25)-P(75)]: 20.7 [15.3- 48.3] v 34.6 [23.8- 64.5] ng/mL and 4 hours postoperatively: 30.4 [17.3-59.9] v 33.3 [25.5-76.7] ng/mL).
  
  
  CONCLUSIONS
  Levosimendan is at least as efficacious as milrinone after corrective congenital cardiac surgery in neonates and infants.
authors.affiliation: Department of Anesthesiology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium. mona.momeni@uclouvain.be
authors.forename: Mona
authors.initials: M
authors.lastname: Momeni
authors.forename: Jean
authors.initials: J
authors.lastname: Rubay
authors.forename: Amine
authors.initials: A
authors.lastname: Matta
authors.forename: Marie-Thérèse
authors.initials: MT
authors.lastname: Rennotte
authors.forename: Francis
authors.initials: F
authors.lastname: Veyckemans
authors.forename: Alain Jean
authors.initials: AJ
authors.lastname: Poncelet
authors.forename: Stéphan
authors.initials: S
authors.lastname: Clement de Clety
authors.forename: Christine
authors.initials: C
authors.lastname: Anslot
authors.forename: Ryad
authors.initials: R
authors.lastname: Joomye
authors.forename: Thierry
authors.initials: T
authors.lastname: Detaille
mesh_terms: D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D006348:Cardiac Surgical Procedures / Q000379:methods; D002675:Child, Preschool; D004311:Double-Blind Method; D006330:Heart Defects, Congenital / Q000188:drug therapy / Q000601:surgery*; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006835:Hydrazones / Q000008:administration & dosage*; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D020105:Milrinone / Q000008:administration & dosage; D011446:Prospective Studies; D011724:Pyridazines / Q000008:administration & dosage*; D000077464:Simendan
chemical_list: D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan; D020105:Milrinone