Levosimendan and Venoarterial ECMO—A Promising Application

Abstract

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Levosimendan for VA‐ECMO weaning: the silver lining

“…Levosimendan can unload the ventricles due to the vasodilatory effect induced by the relaxation of the smooth muscles of the systemic, coronary, and pulmonary vessels. 1 , 2 , 3 Therefore, levosimendan may have a beneficial effect in facilitating VA‐ECMO weaning. 1 , 2 …”

“… 1 , 4 , 5 Examples of limitations include the observational nature of the studies, inconsistency in the VA‐ECMO weaning definition, and the protocols used across the studies; variability in levosimendan dose and time of administration; and the absence of details about inotropes or intra‐aortic balloon pump use. 1 , 3 We published a systematic review and meta‐analysis of seven observational studies ( n = 630) evaluating levosimendan use in VA‐EMCO weaning in critically ill patients. Weaning success rates ranged from 65.0% to 92.0% in the levosimendan group compared with 27.0% to 88.0% in the comparator group (OR 2.89, 95% CI 1.53–5.46; P overall effect = 0.001, I 2 = 49%).…”