Early levosimendan administration is associated with decreased mortality after cardiac surgery

Treskatsch, Sascha; Balzer, Felix; Geyer, Torsten; Spies, Claudia; Kastrup, Marc; Grubitzsch, Herko; Wernecke, Klaus‐Dieter; Erb, Joachim M.; Braun, J.; Sander, Michael

doi:10.1016/j.jcrc.2015.03.008

Cited by 18 publications

(14 citation statements)

References 39 publications

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“…Among clinical scenarios, levosimendan improves RV function and decreases PVR in ischemic RVF and ARDS and after mitral valve replacement surgery [ 95 , 96 ]. Early perioperative levosimendan treatment in cardiac surgery patients with severely impaired perioperative medical condition appears to reduce mortality and morbidity, and a recent European expert opinion was suggested that the optimal time point for initiation levosimendan (0.1 μ g/kg/min) is the day before cardiac surgery [ 97 , 98 ]. However, very recently, two large, randomized, placebo-controlled trials of levosimendan in patients undergoing cardiac surgery have shown no clear advantage over conventional inotropic drugs for the management of perioperative low cardiac output syndrome [ 99 , 100 ].…”

Section: Treatmentmentioning

confidence: 99%

Acute Right Ventricular Dysfunction in Intensive Care Unit

Grignola

Domingo

2017

BioMed Research International

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The role of the left ventricle in ICU patients with circulatory shock has long been considered. However, acute right ventricle (RV) dysfunction causes and aggravates many common critical diseases (acute respiratory distress syndrome, pulmonary embolism, acute myocardial infarction, and postoperative cardiac surgery). Several supportive therapies, including mechanical ventilation and fluid management, can make RV dysfunction worse, potentially exacerbating shock. We briefly review the epidemiology, pathophysiology, diagnosis, and recommendations to guide management of acute RV dysfunction in ICU patients. Our aim is to clarify the complex effects of mechanical ventilation, fluid therapy, vasoactive drug infusions, and other therapies to resuscitate the critical patient optimally.

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Section: Treatmentmentioning

confidence: 99%

Acute Right Ventricular Dysfunction in Intensive Care Unit

Grignola

Domingo

2017

BioMed Research International

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“…Treskatsch et al performed a study in 159 cardiac surgery patients with FEVI < 35% and/or LCOS, who were divided into two groups based on the timing of levosimendan administration. Early administration was found to be related to a lower incidence of kidney failure and a reduced need for renal replacement therapy [14]. In a multicenter, randomized, double-blind, placebo-controlled LICORN study, Caruba et al included 340 patients from 13 hospitals with FEVI < 40% undergoing CABG with cardiopulmonary bypass.…”

Section: Discussionmentioning

confidence: 99%

Preservation of renal function in cardiac surgery patients with low cardiac output syndrome: levosimendan vs beta agonists

et al. 2019

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BackgroundSome studies have been performed to assess the effects of levosimendan on cardiac function when administered to cardiac surgery patients with low cardiac output syndrome (LCOS) in the immediate postoperative period. Levosimendan is an inotropic agent for the treatment of low cardiac output syndrome that seems to have a protective effect on renal function.MethodsIt is a quasi-experimental study. A total of 100 patients with LCOS received either beta-agonists or levosimendan. We assessed the incidence of postoperative kidney failure in cardiac surgery patients. In patients who had kidney failure at diagnosis of LCOS, we examined whether differences existed in the evolution of kidney failure based on the treatment administered for LCOS. The parameters measured included haemodynamics, oxygen supply, and renal function as assessed by the AKI scale. ANOVA, Student’s t-test and Wilcoxon or Friedman tests were used.ResultsUp to 30% of cardiac surgery patients had kidney failure at diagnosis of LCOS. Kidney failure at discharge from the ICU was more frequent in patients who received beta-agonist drugs as compared to those who received levosimendan (p < 0.05).ConclusionThe incidence of kidney failure decreased with the postoperative administration of levosimendan to cardiac surgery patients with LCOS, as compared to beta-agonists.Trial registrationCurrent Controlled Trials ISRCTN 46058317. Date of registration: 7/10/2019.Retrospectively registered.

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“…Обсуждение В нашей работе подтверждено положительное влияние ЛС на параметры гемодинамики и концен-трацию BNP у кардиохирургических больных с ХСН, что совпадает с результатами других исследований [1][2][3][4]. О положительном эффекте ЛС свидетельствует один из последних мета-анализов, проведенный Landoni G, et al, 2016 [5].…”

Section: особенности действия лс у пациентов с различной степенью вырunclassified

Levosimendan in Preoperation Therapy for Cardiosurgery in Patients With Chronic Heart Failure

Бабаев¹,

Еременко²,

Дымова³

et al. 2017

Russ J Cardiol

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Цель. Определение эффективности действия кальциевого сенситайзера левосимендана (ЛС) у пациентов с различной степенью выраженности сер-дечной недостаточности (СН) перед хирургической операцией. Материал и методы. ЛС применяли как компонент терапии СН при подго-товке пациентов к хирургическому вмешательству за 2-4 суток. Доза введения составляла от 0,025 до 0,1 мкг/кг/мин. Болюсное введение препарата не про-водили. Предоперационная группа исследования представлена 108 больными (62% мужчин/ 38% женщин в возрасте от 20 до 72 лет (53±13)) с ХСН III-IV ФК по NYHA, фракция изгнания левого желудочка (ФИЛЖ) составляла в среднем 27±8%. Средний уровень натрийуретического пептида В-типа -1129 (Me 854, Q 25 396, Q 75 1419) пг/мл. Основной этиологией хронической СН у обследуемых пациентов была дилатационная кардиомиопатия: некоронарогенная кардио-миопатия у 30 больных (27,7%), ишемическая кардиомиопатия (ишемическая болезнь сердца, постинфарктный кардиосклероз) у 72 пациентов (66,7%) и приобретенные клапанные пороки сердца у 6 пациентов (5,6%). Для оценки эффективности действия препарата при различной степени выраженности СН пациенты были разделены на подгруппы в зависимости от степени снижения ФИЛЖ (менее 20%, 21-30%, 31-40%, более 40%), повышения уровня давление в легочной артерии (ДЛА) (до 40 мм рт.ст., 40-70 мм рт.ст., более 70 мм рт.ст.). Результаты. Инфузия препарата приводила к статистически значимому уве-личению ФИЛЖ по сравнению с исходным уровнем (57%), снижению ДЛА (64%) и концентрации BNP 77% случаев. Заключение. ЛС является эффективным препаратом, который может исполь-зоваться в целях подготовки больных с СН к кардиохирургическим операциям. Наиболее чувствительными показателями эффективности ЛС являются ДЛА, ФИЛЖ и концентрация BNP. Самая высокая степень эффективности препа-рата наблюдалась при ФИ ≤40%, ДЛА ≥40 мм рт.ст. и уровне BNP ≥600 пг/мл. ЛС, применяемый при подготовке больных с СН к кардиохирургическим вме-шательствам, может использоваться для оценки резервных возможностей миокарда. Aim. To evaluate the efficacy of action of the calcium sensitizer levosimendan (LS) in patients with various grade of heart failure (HF) severity before cardiosurgery. material and methods. LS was applied as a part of HF treatment while preparing patients for surgery in 2-4 days. Performed dose was 0,025 -0,1 µg/kg/min. The drug was not administered in bolus. Preoperation group of participants included 108 patients (62% -men, 38% -women, aged 20 -72 years (53±13)) with CHF III-IV FC by NYHA, with ejection fraction of the left ventricle (LVEF) about in average 27±8%.Mean level of natriuretic B-type peptide was 1129 (Me 854, Q 25 396, Q 75 1419) pg/mL. Main etiology of chronic HF in participants was dilation cardiomyopathy: noncoronary cardiomyopathy in 30 patients (27,7%), ischemic cardiomyopathy (ischemic heart disease, postinfarction cardiosclerosis) in 72 patients (66,7%) and acquired valve defects in 6 patients (5,6%). For assessment of efficacy of the drug in various grade of HF severity, patients were selected to subgrou...

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Early levosimendan administration is associated with decreased mortality after cardiac surgery

Cited by 18 publications

References 39 publications

Acute Right Ventricular Dysfunction in Intensive Care Unit

Acute Right Ventricular Dysfunction in Intensive Care Unit

Preservation of renal function in cardiac surgery patients with low cardiac output syndrome: levosimendan vs beta agonists

Levosimendan in Preoperation Therapy for Cardiosurgery in Patients With Chronic Heart Failure

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