Levosimendan reduces mortality in patients with severe sepsis and septic shock: A meta-analysis of randomized trials

Herz in der Sepsis

“…Die pharmakologische Inhibition der mitochondrialen "permeability transition pore" mittels Ciclosporinderviaten kann die kardiale Funktion verbessern und die Sterblichkeit im Mausmodell der polymikrobiellen Sepsis reduzieren [58]. [113]. Die Autoren schlussfolgern, dass die Therapie mit Levosimendan (0,05-0,2 μg × kgKG -1 × min -1 ) im Vergleich zu anderen (konventionellen) Inotropika mit einer signifikant reduzierten Letalität assoziiert ist (relatives Risiko -0.14).…”

Inotropes and vasopressors

“…Although there is strong evidence of its renoprotective effect, there are still some conflicting results (31,32). Furthermore, there is evidence that levosimendan reduces mortality in patients with severe sepsis and septic shock (33). However, a large clinical trial recently showed that levosimendan does not improve organ function nor does it lower mortality in patients with sepsis (34).…”

Vasoactive agents for the treatment of sepsis

“…Results of these RCTs were combined in a recent meta-analysis, which showed that levosimendan was associated with significantly reduced risk of death as compared to the conventional inotropes (47% vs. 61%; risk difference =−0.14; risk ratio: 0.79; 95% CI: 0.63-0.98; P=0.03). The NNT was seven (70). However, because the effect size is not very large and levosimendan is very expensive, formal recommendation of levosimendan for severe sepsis and septic shock requires evidence from cost-effectiveness studies.…”