Objective To describe our preliminary experience with Levosimendan during the last 4 years, a new calcium-sensitizing agent in critically unwell infants and children with severe heart failure.
Design Retrospective cohort analysis.
Setting Pediatric cardiology intensive care unit.
Patients 8 children aged 2.5 months to 13 yrs (median age 44 months) with severe myocardial dysfunction secondary to endstage heart failure who were inotropedependent (requiring at least one catecholamine).
Interventions A single dose (continuous intravenous infusion over 24 hrs) of Levosimendan was given under continuous hemodynamic monitoring in our intensive care unit.
Six children received a single dose, two children received two doses,
Echocardiographic assessments of ventricular function were made before and 3–5 days after Levosimendan infusion.
Measurements and Main Results Heart rate, systolic pressure, diastolic pressure, mean blood pressure, shortening fraction, the dose of inotrope at the beginning of levosimendan infusion, at 24 hours and 36 hours, ECG result 24 hour after levosimendan infusion.
Conclusions Levosimendan appeared to be a safe and efficacious drug when given to children with uncompensated end-stage heart failure in this size-limited sample. It warrants formal prospective large-cohort evaluation and multicenter trial to determine its safety profile and clinical application in the pediatric population.