Amiet V, et al. – This report highlighted the effect of Levosimendan on cardiac output parameters in cardiac children with low cardiac output syndrome (LCOS). Levosimendan was an effective treatment option in children presenting LCOS after congenital heart surgery. This drug offered improvement of cardiac output, with no undesirable side effects.

• This analysis consisted of 62 children hospitalized in the pediatric intensive care unit (PICU) after cardiac surgery, which demonstrated LCOS not responding to classical catecholamine therapy and who received levosimendan as rescue therapy.
• Before therapy and at 3, 6, 12, and 24 h after the beginning of the levosimendan infusion, LCOS parameters like diuresis, central venous oxygen saturation (SvO₂), venous-to-arterial CO₂ difference (ΔavCO₂), and plasmatic lactate were compared.
•  The effect on the Vasoactive-inotropic score (VIS), adverse events, and mortality was also determined.
• After the beginning of levosimendan infusion, diuresis (1.1 vs. 3.5 ml/kg/h, p = 0.001) and SvO₂ (59.5 vs. 63.3%, p = 0.026) increased significantly during the 24 h of infusion, and at the same time, plasmatic lactate (2.3 vs. 1.3 mmol/l, p < 0.001) decreased.
• ΔavCO₂ (10.8 vs. 9.4 mmHg, p = 0.21) and the VIS (44.5 vs. 22.5, p = 0.143) also decreased, but not significantly.
• No side effects were reported.
• The mortality in this patient group was 16%.