First experiences with intraoperative Levosimendan in pediatric cardiac surgery

• DOI: 10.1007/s00431-008-0834-7
• Publication Date: 2008-09-23T12:16:34Z
• Authors: Wilhelm Alexander...; Dietmar Boethig; Michael Winterhalter; Dirk Huber; Heidi Goerler; Michael Sasse; Robert Sümpelmann
• Keywords: Heart Defects, Congenital; Cardiotonic Agents; Cardiac Output, Low; Hemodynamics; Hydrazones; Infant, Newborn; Infant; Heart; Length of Stay; Respiration, Artificial; 3. Good health; Oxygen; Pyridazines; Intraoperative Period; 03 medical and health sciences; Postoperative Complications; 0302 clinical medicine; Humans; Lactic Acid; Cardiac Output; Cardiac Surgical Procedures; Infusions, Intravenous; Retrospective Studies

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.