| Acute effects of levosimendan on cerebral and systemic perfusion and oxygenation in newborns: an observational study. | |
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MedLine Citation:
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PMID: 20881438 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Cardiovascular drugs play a major role in the pre- and postoperative care in neonates with congenital heart disease. Management strategies aim to optimise contractility, improve diastolic function, maintain adequate preload, and reduce afterload. Levosimendan, a novel inodilator agent, enhances myocardial contractility and causes peripheral and coronary vasodilation. OBJECTIVES: A systematic approach was used to evaluate the acute haemodynamic effects of levosimendan in critically ill infants with low cardiac output syndrome (LCOS). METHODS: Infants received a continuous infusion of levosimendan, at a dose increased stepwise (range 0.1-0.2 μg/kg/min), during 48 h. Two near-infrared units were used to assess cerebral (frontal-parietal, c) and peripheral (thigh, p) perfusion and oxygenation. The changes in cerebral blood volume (ΔCBV), cerebral (cΔHbD) and peripheral (pΔHbD) intravascular oxygenation and the cerebral (cTOI) and peripheral (pTOI) tissue oxygenation index that followed levosimendan administration were continuously monitored. Blood pressure, heart rate, and temperature were continuously recorded. In addition, baseline and end-of-study pH, blood gases, lactate and haematocrit were determined. RESULTS: Seven doses of levosimendan were investigated. The mean study time was 13.3 (7-19) h. Levosimendan produced an increase in cΔHbD (p < 0.05) and pΔHbD (NS) and a decrease in heart rate (p < 0.001) and lactate (p < 0.05). Trends showed an increase in mean blood pressure (NS). These results were independent of the effect of time. Mixed linear model analysis identified blood pressure changes and levosimendan as factors independently associated with cΔHbD. CONCLUSIONS: Levosimendan improves cerebral and systemic perfusion and oxygenation in critically ill infants suffering from LCOS. |
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Authors:
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María Carmen Bravo; María del Carmen Bravo; Paloma López; Fernando Cabañas; Jesús Pérez-Rodríguez; Elia Pérez-Fernández; José Quero; Adelina Pellicer |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-09-25 |
Journal Detail:
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Title: Neonatology Volume: 99 ISSN: 1661-7819 ISO Abbreviation: Neonatology Publication Date: 2011 |
Date Detail:
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Created Date: 2011-03-30 Completed Date: 2011-08-03 Revised Date: 2011-08-11 |
Medline Journal Info:
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Nlm Unique ID: 101286577 Medline TA: Neonatology Country: Switzerland |
Other Details:
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Languages: eng Pagination: 217-23 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 S. Karger AG, Basel. |
Affiliation:
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Department of Neonatology, La Paz University Hospital, Madrid, Spain. m.bravo.laguna@gmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Blood Pressure
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drug effects Cardiac Output, Low / drug therapy*, metabolism Cardiotonic Agents / administration & dosage* Cerebrovascular Circulation / drug effects* Heart Defects, Congenital / metabolism, surgery Heart Rate / drug effects, physiology Hemoglobins / metabolism Humans Hydrazones / administration & dosage* Infant, Newborn Lactic Acid / blood Prospective Studies Pyridazines / administration & dosage* Respiration / drug effects Statistics, Nonparametric |
| Chemical | |
Reg. No./Substance:
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0/Cardiotonic Agents; 0/Hemoglobins; 0/Hydrazones; 0/Pyridazines; 131741-08-7/simendan; 50-21-5/Lactic Acid |
| Comments/Corrections | |
Erratum In:
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Neonatology. 2011;99(4):301 Note: Bravo, María del Carmen [corrected to Bravo, María Carmen]; Quero, José [added] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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