Prophylactic Use of Levosimendan Versus Milrinone in Open Heart Surgery in Infants (Levomil)
Recruitment status was Recruiting
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Purpose
Pediatric patients, especially infants undergoing open heart surgery have a predictable fall in cardiac index 6 to 18 hours after surgery, the so-called low cardiac output syndrome (LCOS). Patients, who have LCOS require more monitoring, more medication and a longer stay in intensive care unit. To prevent LCOS the phosphodiesterase inhibitor milrinone is routinely used during the first 24 hours after surgery. Levosimendan, a calcium- sensitizer improves cardiac muscle contractile force, vascular smooth muscle relaxation and coronary blood flow through calcium sensitization of the myocardial contractile filaments and opening of potassium channels without increasing oxygen consumption of the heart muscle cells. As the myocardium of infants is more calcium dependent than in later life, levosimendan should be of special benefit in this age group. The purpose of this study is to investigate whether levosimendan is superior to milrinone in preventing LCOS in infants after corrective open heart surgery.
| Condition | Intervention | Phase |
|---|---|---|
|
Low Cardiac Output Syndrome |
Drug: Levosimendan Drug: Milrinone |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Phase 2 Prospective, Randomized, Double-Blind Pilot Study on Cardiac Output Following Corrective Open Heart Surgery in Children Less Than One Year: Use of Levosimendan Versus Milrinone. |
- Cardiac output measured by a transesophageal probe [ Time Frame: 48 hours ]
- Changes in mixed venous saturation [ Time Frame: 48 hours ]
- Serum lactate levels [ Time Frame: 48 hours ]
- Cardiac output and ventricular function assessed by echocardiography [ Time Frame: 48 hours ]
- Mean arterial, left atrial and central venous pressure [ Time Frame: 48 hours ]
- Need of catecholamines assessed with the inotropic score [ Time Frame: 48 hours ]
- Urine output [ Time Frame: 48 hours ]
| Estimated Enrollment: | 40 |
| Study Start Date: | September 2007 |
| Arms | Assigned Interventions |
|---|---|
| Experimental: 1 | Drug: Levosimendan |
| Active Comparator: 2 | Drug: Milrinone |
Eligibility| Ages Eligible for Study: | up to 12 Months |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age younger than one year
- corrective open heart surgery with biventricular repair, except tetralogy of fallot
Exclusion Criteria:
- Missing written consent of parents
- Weight less than 3 kg
- preoperative LCOS
- gestational age less than 36 weeks
- preexisting renal failure
- preexisting thrombopenia
- preoperative cardiopulmonary resuscitation
- preoperative use of milrinone or levosimendan
Contacts and Locations| Contact: Evelyn Lechner, MD | +43505546324706 | elechner@aon.at |
| Contact: Hans Gombotz, MD, PHD | +4373278062157 | hans.gombotz@akh.linz.at |
| Austria | |
| Children´s Heart Center Linz | Recruiting |
| Linz, Austria, 4020 | |
| Contact: Evelyn Lechner, MD elechner@aon.at | |
| Contact: Anna Hofer, MD anna.hofer@akh.linzat | |
| Principal Investigator: Evelyn Lechner, MD | |
| Principal Investigator: Anna Hofer, MD | |
| Principal Investigator: | Evelyn Lechner, MD | Children´s Heart Center Linz |
| Study Director: | Hans Gombotz, MD, PHD | General Hospital Linz, Ludwig Boltzmann Gesellschaft |
| Principal Investigator: | Anna Hofer, MD | General Hospital Linz |
| Study Chair: | Gerald Tulzer, MD, PHD | Children´s Heart Center Linz |
More Information
Publications:
| ClinicalTrials.gov Identifier: | NCT00549107 History of Changes |
| Other Study ID Numbers: | 1-365 |
| Study First Received: | October 24, 2007 |
| Last Updated: | October 24, 2007 |
| Health Authority: | Austria: Ethikkommission |
Keywords provided by Ludwig Boltzmann Gesellschaft:
|
low cardiac output syndrome open heart surgery infants Low cardiac output syndrome in infants undergoing corrective open heart surgery |
Additional relevant MeSH terms:
|
Cardiac Output, Low Heart Diseases Cardiovascular Diseases Signs and Symptoms Milrinone Simendan Platelet Aggregation Inhibitors Hematologic Agents Therapeutic Uses Pharmacologic Actions |
Vasodilator Agents Cardiovascular Agents Phosphodiesterase 3 Inhibitors Phosphodiesterase Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Cardiotonic Agents Protective Agents Physiological Effects of Drugs Anti-Arrhythmia Agents |
ClinicalTrials.gov processed this record on June 17, 2013