Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-28T13:31:00.527Z Has data issue: false hasContentIssue false

The use of levosimendan in children with cancer with severe acute cardiac dysfunction: case series and a review of the literature

Published online by Cambridge University Press:  10 May 2013

Alvise Tosoni
Affiliation:
Division of Critical Care Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Anne I. Dipchand
Affiliation:
Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Hadi Mohseni-Bod*
Affiliation:
Division of Critical Care Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
*
Correspondence to: H. Mohseni-Bod, MD, MRCPCH (UK), Division of Critical Care Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G1X8. Tel: +1 416 813 7654, ext 28436; Fax: +1 416 813 7299; E-mail: hadi.mohseni-bod@sickkids.ca

Abstract

We report the use of levosimendan in two febrile, neutropenic children with cancer – one post bone marrow transplant – with acute heart failure following chemotherapy. Initial management with epinephrine, milrinone, and diuresis was unsuccessful. Infusion of levosimendan without a loading dose was added to the ongoing heart failure therapy, which resulted in persistent symptomatic and echocardiographic improvement without major side effects.

Type
Brief Reports
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Papp, Z, et al. Levosimendan: molecular mechanism and clinical implications. Consensus of experts on the mechanisms of action of levosimendan. Int J Cardiol 2012; 159: 8287.Google Scholar
2. Antila, S, Sundberg, S, Lehtonen, LA. Clinical pharmacology of levosimendan. Clin Pharmacokinet 2007; 46: 535552.Google Scholar
3. Mebazaa, A, Barraud, D, Welschbillig, S. Randomized clinical trials with levosimendan . Am J Cardiol 2005; 96: 74G79G.CrossRefGoogle ScholarPubMed
4. Landoni, G, Biondi-Zoccai, G, Greco, M, et al. Effects of levosimendan on mortality and hospitalization. A meta-analysis of randomized controlled studies. Crit Care Med 2012; 40: 634646.Google Scholar
5. Delaney, A, Bradford, C, McCaffrey, J, Bagshaw, SM, Lee, R. Levosimendan for the treatment of acute severe heart failure: a meta-analysis of randomised controlled trials. Int J Cardiol 2010; 138: 281289.Google Scholar
6. Namachivayam, P, Crossland, DS, Butt, WW, Shekerdemian, LS. Early experience with levosimendan in children with ventricular dysfunction. Pediatr Crit Care Med 2006; 7: 445448.CrossRefGoogle ScholarPubMed
7. Ryerson, LM, Alexander, PMA, Butt, WW, Shann, FA, Penny, DJ, Shekerdemian, LS. Rotating inotrope in a pediatric population with decompensated heart failure. Pediatr Crit Care Med 2011; 12: 5760.CrossRefGoogle Scholar
8. Braun, JP, Schneider, M, Dohmen, P, Dopfmer, U. Successful treatment of dilatative cardiomyopathy in a 12-year-old girl using the calcium sensitizer levosimendan after weaning from mechanical biventricular assist support. J Cardiothorac Vasc Anesth 2004; 18: 772774.CrossRefGoogle Scholar
9. Martinez, PL, Erroz, IO, Minaya, SG, Fernandez, LMR. Treatment of acute heart failure using levosimendan for a patient with dilated cardiomyopathy, chronic renal failure, and hypertension. Pediatr Cardiol 2011; 32: 10121016.CrossRefGoogle Scholar
10. Puttonen, J, Kantele, S, Kivikko, M, et al. Effect of severe renal failure and haemodialysis on the pharmacokinetics of levosimendan and its metabolites. Clin Pharmacokinet 2007; 46: 235246.Google Scholar