Levosimendan in Patients with Left Ventricular Dysfunction Undergoing Cardiac Surgery

Mehta, Rajendra H.; Leimberger, Jeffrey D.; Diepen, Sean van; Meza, James M.; Wang, Alice; Jankowich, Rachael; Harrison, Robert W.; Hay, Douglas W. P.; Fremes, Stephen E.; Duncan, Andra I.; Soltesz, Edward G.; Luber, John M.; Park, Soon; Argenziano, Michael; Murphy, Edward; Marcel, Randy J.; Kalavrouziotis, Dimitri; Nagpal, Dave; Bozinovski, John; Toller, Wolfgang; Heringlake, Matthias; Goodman, Shaun G.; Levy, Jerrold H.; Harrington, Robert A.; Anstrom, Kevin J.; Alexander, John H.

doi:10.1056/nejmoa1616218

Cited by 246 publications

(228 citation statements)

References 22 publications

Supporting

Mentioning

208

Contrasting

Unclassified

Order By: Relevance

“…Perioperative. Numerous pharmacological agents including levosimendan, [94][95][96][97] statins, 98-100 N-acetylcysteine, [101][102][103][104] sodium bicarbonate, [105][106][107][108] and erythropoietin [109][110][111][112][113] have, for the most part, failed to demonstrate benefit for the prevention of CS-AKI. A possible exception is dexmedetomidine, for which a number of small or low-quality studies found a reduction in the occurrence of AKI after cardiac surgery.…”

Section: Pharmacological Strategiesmentioning

confidence: 99%

Cardiac and Vascular Surgery–Associated Acute Kidney Injury: The 20th International Consensus Conference of the ADQI (Acute Disease Quality Initiative) Group

Nadim

Forni

Bïhorac

et al. 2018

JAHA

228

191

View full text Add to dashboard Cite

Section: Pharmacological Strategiesmentioning

confidence: 99%

Cardiac and Vascular Surgery–Associated Acute Kidney Injury: The 20th International Consensus Conference of the ADQI (Acute Disease Quality Initiative) Group

Nadim

Forni

Bïhorac

et al. 2018

JAHA

228

191

View full text Add to dashboard Cite

“…None of our other predefined patient‐important outcome measures have been assessed. In the recently published LEVO‐CTS, CHEETAH, and LICORN trials44, 45, 46 no difference in outcome between levosimendan and placebo in patients undergoing planned cardiac surgery was found. Of note, levosimendan was studied as a second‐line inotropic agent in these trials, and other inotropic drugs, such as dobutamine, were permitted.…”

Section: Resultsmentioning

confidence: 98%

Scandinavian SSAI clinical practice guideline on choice of inotropic agent for patients with acute circulatory failure

Møller

Granholm

Junttila

et al. 2018

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

BackgroundAdult critically ill patients often suffer from acute circulatory failure and those with low cardiac output may be treated with inotropic agents. The aim of this Scandinavian Society of Anaesthesiology and Intensive Care Medicine guideline was to present patient‐important treatment recommendations on this topic.MethodsThis guideline was developed according to GRADE. We assessed the following subpopulations of patients with shock: (1) shock in general, (2) septic shock, (3) cardiogenic shock, (4) hypovolemic shock, (5) shock after cardiac surgery, and (6) other types of shock, including vasodilatory shock. We assessed patient‐important outcome measures, including mortality and serious adverse reactions.ResultsFor all patients, we suggest against the routine use of any inotropic agent, including dobutamine, as compared to placebo/no treatment (very low quality of evidence). For patients with shock in general, and in those with septic and other types of shock, we suggest using dobutamine rather than levosimendan or epinephrine (very low quality of evidence). For patients with cardiogenic shock and in those with shock after cardiac surgery, we suggest using dobutamine rather than milrinone (very low quality of evidence). For the other clinical questions, we refrained from giving any recommendations or suggestions.ConclusionsWe suggest against the routine use of any inotropic agent in adult patients with shock. If used, we suggest using dobutamine rather than other inotropic agents for the majority of patients, however, the quality of evidence was very low, implying high uncertainty on the balance between the benefits and harms of inotropic agents.

show abstract

“…На основании этих и других сообщений в 2015 году был сформулирован Европейский консенсус о целесообразности предоперационного введения левосимендана у больных с низкой ФВЛЖ [19][20][21][22]. Также эксперты пришли к мнению, что именно болюсное введение левосимендана ассоциировалось с высокой частотой развития побочных эффектов.…”

Section: Discussionunclassified

Госпитальные Результаты Коронарного Шунтирования И Течение Раннего Послеоперационного Периода У Больных С Низкой Фракцией Выброса Левого Желудочка: Аргументы В Пользу Предоперационной Подготовки Левосименданом

Gazizova¹,

Власова²,

Dzybinskaya³

et al. 2019

Kardiologicheskii Vestnik

View full text Add to dashboard Cite

Госпитальные результаты коронарного шунтирования и течение раннего послеоперационного периода у больных с низкой фракцией выброса левого желудочка: аргументы в пользу предоперационной подготовки левосименданом In-hospital results of Coronary artery surgery and current of the early post-operative period in patients with low left ventricular ejection fraction: arguments in preoperative Levosimendan В.П. ГазизоВа, Э.Е. ВласоВа, Е.В. Дзыбинская, В.В. ГрамоВич, В.П. ВасильЕВ, Д.м. ГаляутДиноВ, а.а ШиряЕВ, р.с. акчурин V.P. GazizoVa, E.E. VlasoVa, E.V. Dzybinskaya, V.V. GramoVich, a.a. shiryaEV, V.P. VasiliEV, D.m. GalyautDinoV, r.s. akchurin institute of cardiology named after a.l. myasnikov of national medical research center of cardiology SummaryObjective. low cardiac output syndrome is the main complication of coronary artery bypass surgery (cabG) in patients with low left ventricular ejection fraction (lVEF), wich increases in-hospital mortality. to reduce the risk of this syndrome is the main goal of preoperative medical preparation. levosimendan (l) in addition to standard therapy for chronic heart failure (chF) is expected to be useful for this purpose due to its ability to maintain oxygen balance in ischemic myocardium and at the same time showing a positive inotropic action. Promising results have already received; there is still a need to accumulate more data.Methods. 59 patients with multivessel coronary disease and lVEF ≤35% who underwent cabG were included. 19 patients received l, administered by a cardiologist, as infusion of 12.5mg for 24± 10,5h, without a bolus, 2 days before surgery (group l). 40 patients, operated earlier, made up the retrospective control group (group c). We compared in-hospital results of cabG in patients with lVEF≤35% who was preoperatively treated only with standard therapy for chF (group c) and who additionally received levosimendan (group l). институт клинической кардиологии имени а.л. мясникова ФГбу «нмиЦ кардиологии» минздрава россии, москва, россия Резюме Введение. синдром низкого сердечного выброса -основное и наиболее опасное осложнение коронарного шунтирования (кШ) у больных с низкой фракцией выброса левого желудочка (ФВлЖ), повышающее госпитальную летальность. снизить риск его развития -главная задача предоперационной медикаментозной подготовки. Помимо стандартных препаратов для лечения сердечной недостаточности (сн) с этой целью используется левосимендан, способный сохранять кислородный баланс ишемизированного миокарда на фоне положительного инотропного действия. Получены обнадеживающие результаты, сохраняется потребность в накоплении данных. Материал и методы. обследованы 59 пациентов с многососудистой коронарной болезнью и ФВлЖ≤35%, которым выполнено кШ. из них 19 пациентов, оперированных в 2016-2017 годах, за 2-3 суток до операции в дополнение к стандартной терапии хронической сн получили предоперационную подготовку левосименданом (12,5 мг в течение 24±10,5 часа, без болюса) и составили группу л. Группу ретроспективного контроля к сформировали 40 пациентов, оперирова...

show abstract

Levosimendan in Patients with Left Ventricular Dysfunction Undergoing Cardiac Surgery

Cited by 246 publications

References 22 publications

Cardiac and Vascular Surgery–Associated Acute Kidney Injury: The 20th International Consensus Conference of the ADQI (Acute Disease Quality Initiative) Group

Cardiac and Vascular Surgery–Associated Acute Kidney Injury: The 20th International Consensus Conference of the ADQI (Acute Disease Quality Initiative) Group

Scandinavian SSAI clinical practice guideline on choice of inotropic agent for patients with acute circulatory failure

Contact Info

Product

Resources

About