The Calcium Sensitizer Levosimendan Gives Superior Results to Dobutamine in Postoperative Low Cardiac Output Syndrome

Perioperative Levosimendan Therapy Is Associated With a Lower Incidence of Acute Kidney Injury After Cardiac Surgery

“…Of these, 16 studies were further excluded because there were no outcome data, and further details could not be obtained by the authors. Five eligible randomized clinical trials were identified and included in the final analysis [37][38][39][40][41] (Table 1). …”

“…[37][38][39]41 The dose varied between either 12-24 mg/kg (as an intravenous bolus) or 0.1-0.2 mg kg 21 min 21 (as a continuous infusion). One author administered only a bolus with 24 mg/kg before the bypass.…”

“…One author administered only a bolus with 24 mg/kg before the bypass. 38 The control was represented by placebo in 3 studies, 38,40,41 by dobutamine in 1 study, 39 and by milrinone in the remaining study. 37 Both dobutamine and milrinone increase the force of contraction of myocardial cells by increasing myocardial intracellular Ca 2+ concentration.…”

Prophylactic treatment with levosimendan: a retrospective matched-control study of patients with reduced left ventricular function

“…However, this decrease of morbidity did not translate into reduced length of stay or mortality. In a recent publication, Levin et al presented a prospective study of 137 patients with LOS after CABG, randomised to receive levosimendan or dobutamine within 6 h after surgery [25]. The levosimendan-treated patients had significantly higher CI and SvO 2 up to 48 h after surgery.…”

Clinical Practice Guideline (CPG). Recommendations on strategy for reducing risk of heart failure patients requiring noncardiac surgery

“…Levosimendan has been shown to be more effective than dobutamine 203,266,267 and phosphodiesterase inhibitors, 216 particularly in patients with depressed LVEF. 216,266---325 The current trend is to administer between 0.1 and 0.2 g/kg/min levosimendan without a loading dose.…”