Clinical Investigations: Congestive Heart FailureCarvedilol therapy in pediatric patients with congestive heart failure: A study investigating clinical and pharmacokinetic parameters*,**,★
Section snippets
Study organization
This study was a prospective, open intervention involving pediatric patients with CHF. The local ethics committee gave approval, and the patients or their parents gave informed consent. In addition, healthy adult volunteers participated in a pharmacokinetic investigation after approval was given by the local ethics committee and informed consent was obtained from each volunteer.
Patients
Between 1997 and 1999, all pediatric patients admitted to our hospital with CHF resulting from dilated cardiomyopathy
Patient characteristics
Fifteen patients participated in the study, and their baseline demographic and clinical characteristics are summarized in Tables II and III.Patients (n) 15 Age (y) 0.12-19.3 Sex (female/male) 4/11 Body weight (kg) 3.1-98.2 CHF etiology Dilated cardiomyopathy (n) 10 Congenital heart disease (n) 5 Ventricular septal defect (n) 1 Hypoplastic left heart syndrome (n) 2 Mitral insufficiency (n) 1 Double outlet right ventricle (n) 1
Discussion
The novel findings of this study include that oral carvedilol added to standard drug therapy in pediatric patients with CHF is well tolerated and associated with an improvement in ventricular function and clinical symptom scores. Children eliminated carvedilol faster than adults, which could result in a different dosing regimen for pediatric patients with CHF to optimize the therapeutic response.
CHF in children is a rare disease with a prevalence of about 3 cases per million. The prognosis of
Acknowledgements
We are indebted to Dr Lise M. Bjerre and Dr Martin Hulpke-Wette (Göttingen, Germany) and Dr Darren McQuire (Dallas, Tex) for helpful comments and for critically reviewing the manuscript.
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Update of Pediatric Heart Failure
2020, Pediatric Clinics of North AmericaCitation Excerpt :In 1987, Ross developed a score tailored to symptoms of infants and younger children (see Table 1).9 In 2002, Laer and colleagues10 developed their own model based on age and 6 variables. By 2012, Ross11 modified his own score to include age-based symptoms.
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2020, Journal of CardiologyCitation Excerpt :In addition to arterial oxygen content (CaO2 = 1.36 × Hb x SaO2 × 10), oxygen delivery (DO2), and oxygen extraction ratio (OER) were calculated as the following equation: DO2 = CO × CaO2, OER = (SaO2 – SvO2) / SaO2. In order to evaluate clinical symptoms of HF, modified Ross score was calculated for all patients [13]. In brief, the modified Ross score consisted of patient’s symptoms (diaphoresis, tachypnea) and findings of physical examination (breathing style, respiratory rate, heart rate, and hepatomegaly), assigning 0 to +2 points for each parameter with a distribution of 0–12 points.
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This study was supported by the Deutsche Stiftung für Herzforschung, Frankfurt, Germany.
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Reprint requests: Stephanie Läer, MD, Institut für Experimentelle und Klinische Pharmakologie und Toxikologie, Abteilung für Pharmakologie, Universitätsklinikum Hamburg-Eppendorf, 20246 Hamburg, Martinistrasse 52, Germany.
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E-mail: [email protected]