Abstract
The aim of this study was to evaluate the safety and the efficacy of levosimendan, a novel calcium sensitizer agent, on postoperative hemodynamic and metabolic parameters of neonates affected by single ventricle anatomy. Twenty consecutive neonates scheduled for the Norwood procedure with Blalock Taussig shunt were prospectively enrolled. All patients received an infusion of levosimendan at 0.1 μg/kg/min commencing 24 hours before surgery, and the infusion was continued for 48 hours after surgery. No side effects (intolerance to the drug, hypotension, arrhythmias) were shown. A median inotropic score (IS) of 37 was necessary to maintain a mean arterial pressure between 45 and 50 mm Hg at intensive care unit (ICU) admission: IS was significantly reduced after 72 hours (P < .05). Brain natriuretic peptide values decreased significantly from 1210 to 459 pg/mL in 72 hours (P < .05). Median SvO2 increased significantly from 38% to 59% during the evaluated period (P < .05). Cerebral near-infrared spectroscopy values were close to 40% at ICU admission with a significant stable increase to 50% after 12 hours (P < .05). Median lactate level was 13 mmol/L at ICU admission but showed a trend to a rapid and significant decrease after 12 hours (P < .05). Median urine output was surprisingly elevated, always remaining between 5.2 and 6.2 mL/kg/h throughout the postoperative period. Survival rate was 85% at 30 days (17/20 patients) and 75% (15/20) at hospital discharge. Levosimendan infusion in a cohort of neonates with univentricular anatomy was safe and potentially beneficial on postoperative hemodynamic and metabolic parameters.
| Original language | English |
|---|---|
| Pages (from-to) | 292-299 |
| Number of pages | 8 |
| Journal | World Journal for Pediatric and Congenital Hearth Surgery |
| Volume | 1 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2010 |
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Keywords
- inotropic score
- levosimendan
- pediatric cardiac surgery
- univentricular heart
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Surgery
- Medicine(all)
- Cardiology and Cardiovascular Medicine
Cite this
Initial Single-Center Experience With Levosimendan Infusion for Perioperative Management of Univentricular Heart With Ductal-Dependent Systemic Circulation. / Garisto, Cristiana; Favia, Isabella; Ricci, Zaccaria; Chiara, Luca di; Morelli, Stefano; Giorni, Chiara; Vitale, Vincenzo; Picardo, Sergio; di Donato, Roberto M.
In: World Journal for Pediatric and Congenital Hearth Surgery, Vol. 1, No. 3, 2010, p. 292-299.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Initial Single-Center Experience With Levosimendan Infusion for Perioperative Management of Univentricular Heart With Ductal-Dependent Systemic Circulation
AU - Garisto, Cristiana
AU - Favia, Isabella
AU - Ricci, Zaccaria
AU - Chiara, Luca di
AU - Morelli, Stefano
AU - Giorni, Chiara
AU - Vitale, Vincenzo
AU - Picardo, Sergio
AU - di Donato, Roberto M.
PY - 2010
Y1 - 2010
N2 - The aim of this study was to evaluate the safety and the efficacy of levosimendan, a novel calcium sensitizer agent, on postoperative hemodynamic and metabolic parameters of neonates affected by single ventricle anatomy. Twenty consecutive neonates scheduled for the Norwood procedure with Blalock Taussig shunt were prospectively enrolled. All patients received an infusion of levosimendan at 0.1 μg/kg/min commencing 24 hours before surgery, and the infusion was continued for 48 hours after surgery. No side effects (intolerance to the drug, hypotension, arrhythmias) were shown. A median inotropic score (IS) of 37 was necessary to maintain a mean arterial pressure between 45 and 50 mm Hg at intensive care unit (ICU) admission: IS was significantly reduced after 72 hours (P < .05). Brain natriuretic peptide values decreased significantly from 1210 to 459 pg/mL in 72 hours (P < .05). Median SvO2 increased significantly from 38% to 59% during the evaluated period (P < .05). Cerebral near-infrared spectroscopy values were close to 40% at ICU admission with a significant stable increase to 50% after 12 hours (P < .05). Median lactate level was 13 mmol/L at ICU admission but showed a trend to a rapid and significant decrease after 12 hours (P < .05). Median urine output was surprisingly elevated, always remaining between 5.2 and 6.2 mL/kg/h throughout the postoperative period. Survival rate was 85% at 30 days (17/20 patients) and 75% (15/20) at hospital discharge. Levosimendan infusion in a cohort of neonates with univentricular anatomy was safe and potentially beneficial on postoperative hemodynamic and metabolic parameters.
AB - The aim of this study was to evaluate the safety and the efficacy of levosimendan, a novel calcium sensitizer agent, on postoperative hemodynamic and metabolic parameters of neonates affected by single ventricle anatomy. Twenty consecutive neonates scheduled for the Norwood procedure with Blalock Taussig shunt were prospectively enrolled. All patients received an infusion of levosimendan at 0.1 μg/kg/min commencing 24 hours before surgery, and the infusion was continued for 48 hours after surgery. No side effects (intolerance to the drug, hypotension, arrhythmias) were shown. A median inotropic score (IS) of 37 was necessary to maintain a mean arterial pressure between 45 and 50 mm Hg at intensive care unit (ICU) admission: IS was significantly reduced after 72 hours (P < .05). Brain natriuretic peptide values decreased significantly from 1210 to 459 pg/mL in 72 hours (P < .05). Median SvO2 increased significantly from 38% to 59% during the evaluated period (P < .05). Cerebral near-infrared spectroscopy values were close to 40% at ICU admission with a significant stable increase to 50% after 12 hours (P < .05). Median lactate level was 13 mmol/L at ICU admission but showed a trend to a rapid and significant decrease after 12 hours (P < .05). Median urine output was surprisingly elevated, always remaining between 5.2 and 6.2 mL/kg/h throughout the postoperative period. Survival rate was 85% at 30 days (17/20 patients) and 75% (15/20) at hospital discharge. Levosimendan infusion in a cohort of neonates with univentricular anatomy was safe and potentially beneficial on postoperative hemodynamic and metabolic parameters.
KW - inotropic score
KW - levosimendan
KW - pediatric cardiac surgery
KW - univentricular heart
UR - http://www.scopus.com/inward/record.url?scp=84990347713&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84990347713&partnerID=8YFLogxK
U2 - 10.1177/2150135110378310
DO - 10.1177/2150135110378310
M3 - Article
AN - SCOPUS:84990347713
VL - 1
SP - 292
EP - 299
JO - World journal for pediatric & congenital heart surgery
JF - World journal for pediatric & congenital heart surgery
SN - 2150-1351
IS - 3
ER -