Myocardial stunning in the neonate

Booker, Peter D.

doi:10.1093/bja/80.3.371

Cited by 21 publications

(18 citation statements)

References 114 publications

(93 reference statements)

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“…It represents a new rescue drug for low cardiac output syndrome, whose off-label use might also be beneficial in selected neonatal cases of cardiac surgery. In addition, during neonatal period, Levo may represent an ideal drug for immature myocardium, characterized by a higher calciumdependent contractility than in adults [12] .…”

Section: Discussionmentioning

confidence: 99%

Levosimendan in Two Neonates with Ischemic Heart Failure and Pulmonary Hypertension

Carolis¹,

Piastra²,

Bersani³

et al. 2011

Neonatology

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We report the successful and safe use of levosimendan, a new calcium-sensitizing agent with positive inotropic and vasodilatory action, in 2 critically ill term newborns with acute heart failure and pulmonary hypertension in the absence of any underlying heart malformation and/or previous cardiosurgical procedures. During the neonatal period, levosimendan may represent an ideal drug for immature myocardium characterized by a higher calcium-dependent contractility than in adults.

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Section: Discussionmentioning

confidence: 99%

Levosimendan in Two Neonates with Ischemic Heart Failure and Pulmonary Hypertension

Carolis¹,

Piastra²,

Bersani³

et al. 2011

Neonatology

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“…Prolonged but reversible myocyte dysfunction due to reperfusion injury is known as "myocardial stunning" (8). Newborns, especially those with episodes of hypoxemia before open-heart surgery, are at high risk to develop "postpump myocardial stunning."…”

Section: Discussionmentioning

confidence: 99%

“…Immature myocytes show reduced sarcoplasmic reticulum calcium pump activity, and the density of sodium-calcium exchangers in the sarcolemma of neonates is higher than in adults. Therefore, the contractility of neonatal myocytes is much more calcium dependent than that of adults (8). The new inodilator levosimendan sensitizes myocardial contractile proteins to calcium and opens adenosine triphosphatedependent potassium channels without increasing myocardial oxygen consumption (1, 2, 7).…”

Section: Discussionmentioning

confidence: 99%

Use of levosimendan, a new inodilator, for postoperative myocardial stunning in a premature neonate

Lechner

Moosbauer

Pinter

et al. 2007

Pediatric Critical Care Medicine

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“…It is manifest as a decrease in cardiac output typically lasting 2–4 h post-operatively (Gillies et al, 2005), and can persist for longer periods without apparent signs of infarction or other serum injury markers (Troponins or CKMB) (Kloner and Jennings, 2001). Stunning occurs in about 10% of adults following cardiac surgery (Weisel, 1993; Vaage and Valen, 1993; Mangano, 1995; Spinale, 1999; Flack et al, 2000; Chang et al, 2002; Anselmi et al, 2004) and in 10–15% of pediatric patients (Parr et al, 1975; Booker, 1998; Ravishankar et al, 2003). Stunning may contribute to low cardiac output syndrome (LCOS) in adults (Algarni et al, 2011) and pediatric patients (Weisel, 1993; Booker, 1998; Spinale, 1999; Wessel, 2001; Allen, 2004; Jones et al, 2005).…”

Section: Five Areas Of Concern With Hyperkalemic Cardioplegiamentioning

confidence: 99%

Hyperkalemic cardioplegia for adult and pediatric surgery: end of an era?

Dobson¹,

Faggian²,

Onorati³

et al. 2013

Front. Physiol.

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Despite surgical proficiency and innovation driving low mortality rates in cardiac surgery, the disease severity, comorbidity rate, and operative procedural difficulty have increased. Today's cardiac surgery patient is older, has a “sicker” heart and often presents with multiple comorbidities; a scenario that was relatively rare 20 years ago. The global challenge has been to find new ways to make surgery safer for the patient and more predictable for the surgeon. A confounding factor that may influence clinical outcome is high K+ cardioplegia. For over 40 years, potassium depolarization has been linked to transmembrane ionic imbalances, arrhythmias and conduction disturbances, vasoconstriction, coronary spasm, contractile stunning, and low output syndrome. Other than inducing rapid electrochemical arrest, high K+ cardioplegia offers little or no inherent protection to adult or pediatric patients. This review provides a brief history of high K+ cardioplegia, five areas of increasing concern with prolonged membrane K+ depolarization, and the basic science and clinical data underpinning a new normokalemic, “polarizing” cardioplegia comprising adenosine and lidocaine (AL) with magnesium (Mg2+) (ALM™). We argue that improved cardioprotection, better outcomes, faster recoveries and lower healthcare costs are achievable and, despite the early predictions from the stent industry and cardiology, the “cath lab” may not be the place where the new wave of high-risk morbid patients are best served.

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Myocardial stunning in the neonate

Cited by 21 publications

References 114 publications

Levosimendan in Two Neonates with Ischemic Heart Failure and Pulmonary Hypertension

Levosimendan in Two Neonates with Ischemic Heart Failure and Pulmonary Hypertension

Use of levosimendan, a new inodilator, for postoperative myocardial stunning in a premature neonate

Hyperkalemic cardioplegia for adult and pediatric surgery: end of an era?

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