Document Detail


Comparison between dobutamine and levosimendan for management of postresuscitation myocardial dysfunction.
MedLine Citation:
PMID:  15753736     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the effects of levosimendan, a nonadrenergic inotropic calcium sensitizer, in comparison with adrenergic dobutamine for the management of postresuscitation myocardial dysfunction following resuscitation from prolonged cardiac arrest. DESIGN: Randomized prospective animal study. SETTING: Animal research laboratory. SUBJECTS: Male Yorkshire-cross domestic pigs INTERVENTIONS: Ventricular fibrillation was induced in male domestic pigs weighing between 35 and 40 kg. Cardiopulmonary resuscitation, including precordial compression and mechanical ventilation, was started after 7 mins of untreated cardiac arrest. Electrical defibrillation was attempted after 5 mins of cardiopulmonary resuscitation. Each animal was successfully resuscitated without pharmacologic intervention. Resuscitated animals were randomized to treatment with levosimendan, dobutamine, or saline placebo. The inotropic agents or an equivalent volume of placebo diluents was administered 10 mins after restoration of spontaneous circulation. Levosimendan was administered in a loading dose of 20 microg.kg over 10 mins followed by a 220-min infusion of 0.4 microg.kg.min. Dobutamine was infused into the right atrium in an amount of 5 microg.kg.min. Treatment was continued for a total of 230 mins. MEASUREMENTS AND MAIN RESULTS: Levosimendan and dobutamine produced comparable increases in cardiac output. However, levosimendan produced significantly greater left ventricular ejection fraction and fractional area changes compared with dobutamine and saline placebo. CONCLUSIONS: Levosimendan has the potential of improving postresuscitation myocardial function. It is likely to serve as an alternative to dobutamine as an inotropic agent for management of postresuscitation myocardial dysfunction.
Authors:
Lei Huang; Max Harry Weil; Wanchun Tang; Shijie Sun; Jinglan Wang
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Critical care medicine     Volume:  33     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-08     Completed Date:  2005-04-08     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  487-91     Citation Subset:  AIM; IM    
Affiliation:
Institute of Critical Care Medicine, Palm Springs, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Animals
Cardiomyopathies / prevention & control*
Cardiopulmonary Resuscitation*
Cardiotonic Agents / therapeutic use*
Dobutamine / therapeutic use*
Heart Arrest / therapy*
Hydrazones / therapeutic use*
Male
Myocardial Stunning / prevention & control
Prospective Studies
Pyridazines / therapeutic use*
Random Allocation
Swine
Grant Support
ID/Acronym/Agency:
HL54322/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 0/Hydrazones; 0/Pyridazines; 131741-08-7/simendan; 34368-04-2/Dobutamine
Comments/Corrections
Comment In:
Crit Care Med. 2005 Mar;33(3):668-70   [PMID:  15753763 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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