Renal and Neurologic Benefit of Levosimendan vs Dobutamine in Patients With Low Cardiac Output Syndrome After Cardiac Surgery: Clinical Trial FIM-BGC-2014-01

Guerrero-Orriach, José Luis; Malo-Manso, Alfredo; Ramírez-Aliaga, M.; Vela, Ana Isabel Florez; Galán-Ortega, Manuel; Moreno-Cortes, Isabel; Gonzalez-Almendros, Inmaculada; Ramirez-Fernandez, A; Ariza-Villanueva, Daniel; Escalona-Belmonte, J J; G, Quesada-Muñoz; Haro, Enrique Sepúlveda; Romero-Molina, Salvador; Bellido, I.; Gómez-Luque, A.; Rubio-Navarro, Manuel; Alcaide-Torres, Juan; Santiago‐Fernández, Concepción; Garrido‐Sánchez, Lourdes; Cruz-Mañas, Jose

doi:10.3389/fphar.2020.01331

Cited by 10 publications

(5 citation statements)

References 40 publications

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“…The outcome of our study revealed ESRD with regular hemodialysis occurred in 2% of the patients, however, Lannemyr, et al reported that levosimendan increases glomerular filtration rate and thus may be the preferred inotropic agent for treating patients with the cardiorenal syndrome (11) which is comparable with Guerrero-Orriach, et al who found that levels of creatinine decreased in the levosimendan treated patients, showing significant variations at 24 and 48 h after treatment (12). Our study showed that there were no statistically significant differences between studied groups in myocardial infarction.…”

Section: Discussionsupporting

confidence: 67%

The role of levosimendan as inotropic agents in patients with LV dysfunction admitted to ICU post cardiac surgery

Hussein

Batah

Selit

et al. 2022

ijhs

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BACKGROUND: Coronary artery bypass graft (CABG) surgery is the standard of care for the management of patients with three-vessel and left main coronary artery disease (CAD) with viable myocardium. Positive inotropic agents are the treatment of choice in patients with LV dysfunction post CABG. Levosimendan is an inotropic drug that has three major mechanisms of action: positive inotropy, vasodilation, and cardiac cytoprotection. Levosimendan is a calcium sensitizer, it improves myocardial contractility by sensitising troponin C to calcium without increasing myocardial oxygen consumption and without impairing relaxation and diastolic function. AIM: The aim of this study was to determine the effect of levosimendan compared to the conventional inotropic agents on the outcomes of patients with LV dysfunction undergoing CABG. METHODS: It is a prospective observational study that patients were divided into 2 groups of 50 patients each. Group A received intravenous levosimendan (at a dose of 0.2μg per kilogram of body weight per minute for 1 hour, followed by a dose of 0.1μg per kilogram per minute for 23 hours), with the infusion started at the induction of anesthesia while Group B which included patients who received conventional drugs. Clinical examination, Hemodynamic data and Laboratory investigations pre-operative and post-operative were collected.

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Section: Discussionsupporting

confidence: 67%

The role of levosimendan as inotropic agents in patients with LV dysfunction admitted to ICU post cardiac surgery

Hussein

Batah

Selit

et al. 2022

ijhs

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“…The same research group [ 80 ] has also conducted a more conventionally configured RCT in 60 patients with confirmed LCOS after cardiac surgery, comparing the impact on kidney failure of levosimendan (0.1 μg/kg/min for 24 h) or dobutamine (starting infusion rate 5 μg/kg/min, thereafter variable according to response). Renal status was assessed using the acute kidney injury scale (AKIS).…”

Section: In the Presence Of Renal Dysfunction/failurementioning

confidence: 99%

Levosimendan in intensive care and emergency medicine: literature update and expert recommendations for optimal efficacy and safety

Girardis

Béttex

Bojan

et al. 2022

J Anesth Analg Crit Care

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The inodilator levosimendan, in clinical use for over two decades, has been the subject of extensive clinical and experimental evaluation in various clinical settings beyond its principal indication in the management of acutely decompensated chronic heart failure. Critical care and emergency medicine applications for levosimendan have included postoperative settings, septic shock, and cardiogenic shock. As the experience in these areas continues to expand, an international task force of experts from 15 countries (Austria, Belgium, China, Croatia, Finland, France, Germany, Greece, Hungary, Italy, the Netherlands, Spain, Sweden, Switzerland, and the USA) reviewed and appraised the latest additions to the database of levosimendan use in critical care, considering all the clinical studies, meta-analyses, and guidelines published from September 2019 to November 2021. Overall, the authors of this opinion paper give levosimendan a “should be considered” recommendation in critical care and emergency medicine settings, with different levels of evidence in postoperative settings, septic shock, weaning from mechanical ventilation, weaning from veno-arterial extracorporeal membrane oxygenation, cardiogenic shock, and Takotsubo syndrome, in all cases when an inodilator is needed to restore acute severely reduced left or right ventricular ejection fraction and overall haemodynamic balance, and also in the presence of renal dysfunction/failure.

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“…Due to its calcium-sensing properties, levosimendan may be more beneficial in relaxing the myocardium compared to catecholamines during diastole [22]. Levosimendan can effectively protect liver and kidney functions while preserving heart function, regardless of the presence of hepatic or renal impairment before it is used [23][24][25][26][27][28]. Partly of these protective effects due to their antiinflammatory and anti-apoptotic properties [29,30].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Levosimendan Administration in Heart Transplant Patients with Severe Hepatic and Renal Impairment: A Retrospective Study

Qiang

Lan

Guo

et al. 2023

HSF

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Background: The cardio-renal syndrome and hepatic impairment play a critical role in end-stage heart failure (HF). Levosimendan is an effective inotropic agent used to maintain cardiac output similar to classic cardiotonic like dobutamine/dopamine. This current research aims to investigate the clinical outcomes of levosimendan and dobutamine/dopamine in Chinese heart transplant awaiting patients with severe hepatic or renal impairment. Methods: We performed a retrospective analysis of 568 heart transplant awaiting individuals with severe hepatic or renal impairment who treated with levosimendan or dobutamine/dopamine in our institution between January 2015 and December 2020. Univariate Cox proportional hazard models and Kaplan-Meier survival curves were applied. The primary endpoint was defined as death included inhospital mortality and the mortality at 30 days, 90 days, 180 days and 1 year after heart transplantation. Results: There were no significant differences in mortality rate at 30, 90, 180 days and 1 years after heart transplantation between the levosimendan and non-levosimendan groups, or between subgroups of patients with severe hepatic impairment or renal impairment. The results were consistent before and after propensity score matching. Conclusions: In the population with advanced heart failure awaiting heart transplantation, levosimendan did not increase short- or long-term mortality rates after surgery compared to dobutamine/dopamine, regardless of their hepatic or renal function. Severe hepatic or renal impairment were not necessarily considered a contraindication for levosimendan in these patients.

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Renal and Neurologic Benefit of Levosimendan vs Dobutamine in Patients With Low Cardiac Output Syndrome After Cardiac Surgery: Clinical Trial FIM-BGC-2014-01

Cited by 10 publications

References 40 publications

The role of levosimendan as inotropic agents in patients with LV dysfunction admitted to ICU post cardiac surgery

The role of levosimendan as inotropic agents in patients with LV dysfunction admitted to ICU post cardiac surgery

Levosimendan in intensive care and emergency medicine: literature update and expert recommendations for optimal efficacy and safety

Preoperative Levosimendan Administration in Heart Transplant Patients with Severe Hepatic and Renal Impairment: A Retrospective Study

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