{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T23:04:21Z","timestamp":1792623861660,"version":"4.5.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,9,10]],"date-time":"2020-09-10T00:00:00Z","timestamp":1599696000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p\/>\n                  <jats:p>Levosimendan use is associated with more successful decannulation from veno-arterial extracorporeal membrane oxygenation (VA ECMO) in adults. We sought to determine the role of levosimendan in children who required VA ECMO after cardiac surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>This observational study compares the outcomes of children who required VA ECMO after cardiac surgery and received levosimendan for weaning with those who did not receive the drug. A doubly robust estimation methodology (inverse probability of treatment weighting with regression adjustment) was used to balance study covariates (age, weight, sex, lactate pre-ECMO, vasoactive-inotropic score pre-ECMO, ECMO indication, ECMO modality, Risk Adjustment for Congenital Heart Surgery-1 category), and the final model was further adjusted for duration of ECMO.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Between January 2012 and December 2018, 118 eligible children received 145 ECMO runs [failed weaning from cardiopulmonary bypass, 67\/145 (46%); low cardiac output state, 30\/145 (21%); extracorporeal cardiopulmonary resuscitation, 47\/145 (32%); other reasons in 1]. Levosimendan was administered before decannulation in 54\/145 (37%) runs. The median time to start levosimendan after ECMO cannulation was 39\u2009h (interquartile range, 14\u201383\u2009h). The unadjusted rates of weaning failure in the levosimendan vs control group were 7% (4\/54) vs 19% (17\/91). In the controlled analysis, levosimendan was associated with decreased risk of weaning failure [adjusted relative risk (95% confidence interval), 0.20 (0.07\u20130.57)] and decreased risk of in-hospital mortality [adjusted relative risk (95% confidence interval), 0.45 (0.26\u20130.76)].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Levosimendan administration in children requiring VA ECMO after cardiac surgery was associated with decreased risk of weaning failure and decreased in-hospital mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaa275","type":"journal-article","created":{"date-parts":[[2020,7,14]],"date-time":"2020-07-14T19:07:18Z","timestamp":1594753638000},"page":"262-268","source":"Crossref","is-referenced-by-count":11,"title":["Role of levosimendan in weaning children requiring veno-arterial extracorporeal membrane oxygenation after cardiac surgery"],"prefix":"10.1093","volume":"59","author":[{"given":"Kevin C","family":"Pan","sequence":"first","affiliation":[{"name":"Intensive Care Unit, The Royal Children\u2019s Hospital, Melbourne, VIC, Australia"},{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sai","family":"Shankar","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, The Royal Children\u2019s Hospital, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnny","family":"Millar","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, The Royal Children\u2019s Hospital, Melbourne, VIC, Australia"},{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, VIC, Australia"},{"name":"Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Chiletti","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, The Royal Children\u2019s Hospital, Melbourne, VIC, Australia"},{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, VIC, Australia"},{"name":"Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warwick","family":"Butt","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, The Royal Children\u2019s Hospital, Melbourne, VIC, Australia"},{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, VIC, Australia"},{"name":"Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"d\u2019Udekem","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, VIC, Australia"},{"name":"Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia"},{"name":"Cardiac Surgery, The Royal Children\u2019s Hospital, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siva P","family":"Namachivayam","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, The Royal Children\u2019s Hospital, Melbourne, VIC, Australia"},{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, VIC, Australia"},{"name":"Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,9,10]]},"reference":[{"key":"2021010414503672000_ezaa275-B1","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1093\/bja\/aew151","article-title":"Beneficial effects of levosimendan on survival in patients undergoing 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