Postoperative low cardiac output syndrome has been shown to have both a central and a peripheral
vascular involvement. Therefore, inodilators which provide with a combination of positive
inotropic and vasodilating therapy, conceptually should be an ideal form of treatment. However, contradictory
data on these drugs exist. Phosphodiesterase inhibitors (e.g. milrinone) and more recently
calcium sensitizers (e.g. levosimendan) have been most commonly used groups in the clinical setting.
This review will summarize the pharmacology of inodilators with a special foccus on current clinical evidence. This article
addresses the sixth of eight topics comprising the special issue entitled “Pharmacologic strategies with afterload reduction
in low cardiac output syndrome after pediatric cardiac surgery”.
Keywords: Cardiac output syndrome, inodilators, levosimendan, milrinone, pediatric cardiac surgery, pharmacology.
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