Question 2 Is levosimendan better than milrinone in preventing post operative low cardiac output syndrome and improving cardiac function in children with congenital heart disease?

Scenario You work in a paediatric cardiac intensive care unit (ICU), the unit protocol is to start prophylactic milrinone intraoperatively to prevent low cardiac output syndrome (LCOS). You receive a patient for whom levosimendan was started intraoperatively instead of milrinone, and you wonder whether levosimendan is superior to milrinone. Structured clinical question In postoperative congenital heart disease children (population), is levosimendan (intervention) better than milrinone (comparison) in improving cardiac function and prevention of LCOS (outcome), shown by heart rate, cardiac output/stroke volume, lactate clearance, inotrope requirement, markers of cardiac damage (troponin) and myocardial oxygen consumption (pressure rate index) Search strategy A literature search was performed using The Cochrane Library, Pubmed and Medline using key words ‘levosimendan and milrinone’ ‘pediatric cardiac surgery’, which yielded 10 studies and further web search was done, which yielded 18 more relevant studies. After analysing the abstracts, there were nine...
Source: Archives of Disease in Childhood - Category: Pediatrics Authors: Tags: Archimedes Source Type: research