Document Detail


Beneficial effects of levosimendan in infants with sepsis-associated cardiac dysfunction: report of 2 cases.
MedLine Citation:
PMID:  23034494     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
ABSTRACT: Although international guidelines for hemodynamic support of pediatric septic shock suggest considering the potent calcium sensitizer inodilator levosimendan as a second-line inotropic agent to treat cold hypodynamic shock resistant to catecholamines, clinical experience in septic infants is lacking. We report the beneficial effects of levosimendan infusion in 2 infants (39 and 64 days old) with low cardiac output septic shock (ejection fraction, 29% and 33%; fractional shortening, 10% and 16% respectively) refractory to volume replacement and to the catecholamines dopamine and dobutamine. Levosimendan infusion (0.15 µg/kg/min) promptly increased both patients' myocardial contractility and improved tissue perfusion, thereby reducing lactate levels and increasing urine output. The only adverse effect was moderate hypotension in one infant, who reversed by adding norepinephrine to levosimendan. This clinical experience confirms the potential beneficial effects of levosimendan infusion to restore hemodynamics in infants with low cardiac output septic shock resistant to catecholamines.
Authors:
Paola Papoff; Elena Caresta; Paolo Versacci; Raffaella Pinto; Corrado Moretti; Fabio Midulla
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric emergency care     Volume:  28     ISSN:  1535-1815     ISO Abbreviation:  Pediatr Emerg Care     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8507560     Medline TA:  Pediatr Emerg Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1062-5     Citation Subset:  IM    
Affiliation:
From the Department of Pediatrics PICU, Sapienza University; and Department of Anesthesiology and Intensive Care, Sacro Cuore Catholic University, Rome, Italy.
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