Goyer I, Brossier D, Toledano B
Department of pharmacy, CHU Sainte-Justine, 3175 Côte-Ste-Catherine, H3T1C5 Montreal, QC, Canada.
Department of pediatric intensive care unit, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen, France.
Arch Pediatr. 2018 Feb;25(2):132-135. doi: 10.1016/j.arcped.2017.12.003. Epub 2018 Feb 1.
Decompensated heart failure in children requires rapid and aggressive support. In refractory cases, invasive supportive care is essential to ensure cardiac output. This results in lengthy pediatric intensive care unit (PICU) stays, secondary morbidity, and high cost. Levosimendan may help palliate the pitfalls encountered with the usual treatment. It has been shown to improve hemodynamics and decrease morbidity and mortality from heart failure in adult trials and pediatric cohorts. We report the case of a 15-year-old boy with dilated cardiomyopathy and refractory ventricular dysfunction who was weaned from continuous inotropes and discharged from the PICU with levosimendan while waiting for heart transplantation.
儿童失代偿性心力衰竭需要迅速且积极的支持治疗。在难治性病例中，侵入性支持治疗对于确保心输出量至关重要。这会导致患儿在儿科重症监护病房（PICU）住院时间延长、出现继发性并发症以及费用高昂。左西孟旦可能有助于缓解常规治疗中遇到的问题。在成人试验和儿科队列研究中，已证明它能改善血流动力学并降低心力衰竭的发病率和死亡率。我们报告了一例15岁患有扩张型心肌病和难治性心室功能障碍的男孩，在等待心脏移植期间，使用左西孟旦后成功停用持续静脉输注的正性肌力药物并从PICU出院。
