Levosimendan and other inotropes in pediatric intensive care
DOI:
https://doi.org/10.37051/mir-34-001999Keywords:
Cardiogenic shock, Catecholamines, Inotropic agent, Levosimendan, PediatricAbstract
Pediatric cardiogenic shock is rare but serious, with in-hospital mortality estimated between 7 to 26%. Successful management relies on engaging in an interdisciplinary, team-coordinated care approach with early recognition and escalation of care adapted specifically to each patient. Adequate use of inotropic agents is the cornerstone of treatment for cardiogenic shock. However, this medical treatment is not standardized due to the heterogeneity of potential etiologies and the lack of prospective randomized clinical trials in pediatrics. In fact, most current strategies rely largely on data extrapolated from adult studies.
After a physiopathological review of myocardial contractility and the action of inotropic agents, this review will focus on the different inotropes used in Pediatric Intensive Care, in particular milrinone, dobutamine, dopamine, adrenaline, norepinephrine, vasopressin and especially levosimendan. The final goal is to help in decision-making for inotropic therapy in these serious situations.
