Enoximone in newborns with refractory postoperative low-output states (LOS)

Enoximone was administered to 16 newborns with postoperative,catecholamine-refractory cardiac low-output states in addition to high-dose catecholamine treatment. Haemodynamic changes were assessed atbaseline and during treatment. Haemodynamic parameters were improved in 12newborns ("responders"), 9 of these survived. Three responders died; onefrom cardiac low-output and 2 from uncorrectable congenital heart diseaseverified by autopsy. Four newborns did not respond to enoximone therapy("non-responders") and died. The haemodynamic effects of enoximone werecharacterized by an increase in cardiac index (+160%, P less than 0.0008),and a fall in right (-26%, P less than 0.0004) and left (-34%, P less than0.003) atrial pressures. It is concluded that enoximone can be an effectiveagent in the treatment of cardiac low- output states refractory tohigh-dose catecholamines in neonates up to 7 months old.