Inotropes for the prevention of low cardiac output syndrome and mortality for paediatric patients undergoing surgery for congenital heart disease: a network meta-analysis.

Summary

This Cochrane network meta-analysis of 13 randomised trials (937 children) compares prophylactic inotropes — levosimendan, milrinone and dobutamine — against each other or placebo after cardiopulmonary bypass surgery for congenital heart disease. Outcomes include 30-day mortality, low cardiac output syndrome, ICU and hospital stay, duration of ventilation, and adverse events, with certainty graded using CINeMA. Levosimendan and milrinone were associated with reduced LCOS, while effects on length of stay and ventilation were largely unchanged and adverse events may be increased. The authors highlight that the evidence rests on few small heterogeneous studies with short follow-up.

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