Document Detail

Newer Inotropes in Pediatric Heart Failure.
MedLine Citation:
PMID:  21386708     Owner:  NLM     Status:  Publisher    
In the cardiac setting in pediatrics, inotropic support is often employed based on the extrapolation from adult studies, the underlying pathophysiology, pharmacodynamics of inotropes, and anecdotal experience. Large pediatric critical care studies involving inotropic support are rare. Levosimendan, a calcium-sensitizing agent with inotropic and lusitropic properties, is a pyridazole dinitrate derivative with linear pharmacokinetics and a relatively short half life, although an active metabolite, namely OR-1876, has a half life of 70-80 hours accounting for a prolonged effect. Albeit few, pediatric studies involving levosimendan suggest similar pharmacokinetics to adults with heart failure, an efficacy at least equal to that of milrinone, favorable myocardial oxygen effects, and an ability to decrease concomitant catecholamine dosing. Levosimendan may be a promising new agent in pediatrics but further experience and study is warranted. Finally, istaroxime, a calcium cycling agent that is in the beginnings of adult study, may be another inotrope with lusitropic properties that might be applicable to pediatric patients.
Timothy M Hoffman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-26
Journal Detail:
Title:  Journal of cardiovascular pharmacology     Volume:  -     ISSN:  1533-4023     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-3-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902492     Medline TA:  J Cardiovasc Pharmacol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Nationwide Children's Hospital Heart Center and The Ohio State University College of Medicine, Columbus, OH.
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