[Enoximone in the treatment of postoperative low cardiac output syndrome in pediatric heart surgery. Open study in tetralogy of Fallot]

Abstract

Objective: To evaluate the role of the phosphodiesterase inhibitor enoximone in low output states (LOS) following cardiac operations in congenital heart diseases.

Design: This was an unblinded, retrospective, open study. Hemodynamic effects of intravenous enoximone were investigated in 130 patients--70 adults and 60 pediatrics--offered to our Department from 1992 to 1995. To avoid multifactorial events due to different cardiopathies, our analysis was limited to 24 newborns and children operated on for correction of tetralogy of Fallot (TOF).

Setting: Cardiac surgery ICU of a Regional Hospital in Italy.

Methods: Retrospective analysis of 24 cases of postoperative LOS in surgical corrected TOF, treated with enoximone, were compared with a control group treated with conventional inotropic drugs.

Data analysis: Data were compared by "t"-Student's test for impaired data.

Results: Significative cardiac function improvement in treated group, demonstrated by an increased systemic pressure values, by decreased right chambers pressures and by significative improvement in oxygen mixed venous saturation. Better hemodynamic recovery after ICU discharge. No significant side effects were detected.

Conclusions: Enoximone is, suggested also in pediatric patients in the management of refractory LOS following open heart surgery, especially when a long-standing treatment is predictable (more than 72-96 hrs).