Gutiérrez-Riveroll Karla Itzel, Mejía Picazo Héctor Jorge, Dosta-Herrera Juan José
Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital General "Dr. Gaudencio González Garza", Departamento de Anestesia Pediátrica, Quirófano del Séptimo Piso. Ciudad de México, México.
Rev Med Inst Mex Seguro Soc. 2022 May 2;60(3):304-314.
Tetralogy of Fallot is one of the most frequent cyanotic heart diseases in our country, occupying the second place reported by the national health program 2007- 2012 and its prevalence is around 11%. Patients undergoing correction for tetralogy of Fallot are considered patients with a prolonged ischemic time and a high risk of presenting low cardiac output syndrome.
To compare levosimendan with milrinone to prevent low cardiac output syndrome in patients undergoing tetralogy of Fallot correction.
Randomized controlled open, prospective, longitudinal and comparative clinical trial. The sample size consisted of 19 patients, with a 95% confidence level. Group 1: levosimendan 0.1 mcg/kg/min from anesthetic induction. Group 2: conventional management with milrinone 0.5 mcg/kg/min.
When comparing the final measurements, it can be observed that the mean arterial pressure of the intervention group (levosimendan) was statistically significant (p = 0.04), both in the intraoperative measurement and in the final measurement. When comparing uresis, we found that the intervention group had a greater amount of uresis (p = 0.03). Regarding lactate, both in the intraoperative measurement (p = 0.002) and in the final measurement (p = 0.02), a lower amount was found in the intervention group.
The results in favor of the use of levosimendan were reported, demonstrating the prevention of low cardiac output syndrome.
法洛四联症是我国最常见的青紫型心脏病之一，在2007 - 2012年国家卫生项目报告中占第二位，其患病率约为11%。接受法洛四联症矫治的患者被认为是缺血时间延长且发生低心排血量综合征风险较高的患者。
比较左西孟旦与米力农在预防法洛四联症矫治患者低心排血量综合征方面的效果。
随机对照开放、前瞻性、纵向和比较性临床试验。样本量为19例患者，置信水平为95%。第1组：从麻醉诱导开始给予左西孟旦0.1微克/千克/分钟。第2组：采用米力农0.5微克/千克/分钟的常规治疗。
比较最终测量结果时可以观察到，干预组（左西孟旦）的平均动脉压在术中测量和最终测量时均具有统计学意义（p = 0.04）。比较尿量时，我们发现干预组尿量更多（p = 0.03）。关于乳酸，干预组在术中测量（p = 0.002）和最终测量（p = 0.02）时的含量均较低。
报告了支持使用左西孟旦的结果，表明其可预防低心排血量综合征。
