The Effects of Levosimendan in Cardiac Surgery Patients with Poor Left Ventricular Function

Hert, Stefan De; Lorsomradee, Suraphong; Cromheecke, S.; Linden, Philippe J. Van der

doi:10.1213/01.ane.0000256863.92050.d3

Cited by 163 publications

(104 citation statements)

References 38 publications

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“…Mortality was similar in the two groups [18]. De Hert et al have published a prospective randomised study of 30 patients with a LVEF 30% who received either levosimendan and dobutamine or milrinone and dobutamine [19]. In contrast to our work, De Hert showed that levosimendan resulted in a higher postoperative SVI compared to controls.…”

Section: Discussioncontrasting

confidence: 62%

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

Kolseth

Nordhaug

Stenseth

et al. 2009

European Journal of Cardio-Thoracic Surgery

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Section: Discussioncontrasting

confidence: 62%

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

Kolseth

Nordhaug

Stenseth

et al. 2009

European Journal of Cardio-Thoracic Surgery

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“…They used loading dose of 12 ug/kg over 10 mins followed by 0.1 ug/kg/min for 12 hrs and showed that cardiac index, stroke volume, was significantly increased but systemic vascular resistance and PCWP was significantly low. De Hert, et al [20] have recently shown that Levosimendan in combination with dobutamine maintained stroke volume better than milrinone, in combination with dobutamine in cardiac surgery patients with a preoperative ejection fraction <30%. Tritapepe et al [21] showed that lower postoperative Troponin-I levels with levosimendan prophylaxis .…”

Section: Discussionmentioning

confidence: 99%

Outcome of Prophylactic Use of Levosimendan andMilrinone in Open Heart Surgery With CompromisedVentricular Function–A Comparative Study

Jana¹,

Nayak²,

Biswal³

2016

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Background: Compromised ventricular function complicates the postoperative course after open heart surgery. Incidence of low-output syndrome (LOS) after cardiopulmonary bypass(CPB) is 30%. Vaso active therapy is required for weaning from bypass. Levosimendan is one of the new class of inodilator useful in refractory cardiac failure. Objective: The aim of this randomized control trial is to detect whether prophylactic levosimendan infusion is superior to milrinone in preserving better tissue perfusion, in decreasing complications related to low output syndromes and better hemodynamic control and to evaluate the efficacy of intravenous levosimendan infusion in decreasing the use of high dose of conventional inotropes and consequent prolonged hospitalization in open heart surgery patients with preoperative compromised ventricular function. Methods: Thirty consecutive patients with compromised cardiac function belongs to American Society of Anesthesiologists(ASA) physical status III who underwent open-heart surgery with CBP were randomly divided into two groups. Gr-L received levosimendan (loading dose of 12 μg/kg over 10 mins followed by infusion dose of (0.1 μg/kg /min ) and Gr-M received milrinone loading dose of 50 μg/kg over 10 mins followed by infusion dose of (0.5 μg/kg/ min )after anesthesia induction. Hemodynamic profile, mixed or central venous oxygen saturation (SVO2, SCVO2) which are surrogate markers for cardiac output, tissue perfusion were recorded, and blood obtained for troponin level. Results: SVO2 and SCVO2 were significantly higher in Gr L versus Gr M. Postoperative troponin-I concentrations, need of other inotropes incidence of arrhythmia, re-intubation, Intensive care unit(ICU) stay and hospital stay were significantly decreased in Gr L. Conclusion: Prophylactic levosimendan infusion maintains better hemodynamic control, tissue perfusion, myocardial protection and lesser complications in patients with compromised ventricular function.

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“…1 shows the flow of studies and the reasons for exclusion. Of the trials included, 16 [12][13][14]17,18,[31][32][33][34][35][36][37][38][39][40][41] Table 2 Summary of the validity assessments of randomised clinical trials of levosimendan in patients with acute severe heart failure.…”

Section: Study Characteristicsmentioning

confidence: 99%

Levosimendan for the treatment of acute severe heart failure: A meta-analysis of randomised controlled trials

Delaney

Bradford

McCaffrey

et al. 2010

International Journal of Cardiology

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The Effects of Levosimendan in Cardiac Surgery Patients with Poor Left Ventricular Function

Abstract: In cardiac surgery patients with a low preoperative ejection fraction, stroke volume was better maintained with the combination of dobutamine with levosimendan than with the combination of dobutamine with milrinone.

Cited by 163 publications

References 38 publications

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

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

Outcome of Prophylactic Use of Levosimendan andMilrinone in Open Heart Surgery With CompromisedVentricular Function–A Comparative Study

Levosimendan for the treatment of acute severe heart failure: A meta-analysis of randomised controlled trials

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