Document Detail


Efficacy and safety of perioperative infusion of levosimendan in patients with compromised cardiac function undergoing open-heart surgery: importance of early use.
MedLine Citation:
PMID:  17702589     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Levosimendan is a promising new inotrope. We investigate the proper time for its infusion during or after open-heart surgery to avoid complications related with low-output syndrome and high dosage of inotropes. METHODS: Forty-five consecutive patients were randomised to receive levosimendan in addition to the conventional therapy, its infusion starting in the operating theatre (Group OT) or in the ICU (Group ICU) when low-output syndrome was certified and were consequently dependent on classical inotropic support and IABP. Levosimendan was infused at a rate of 0.1 microg/kg min without loading dose, the infusion being for at least 24h to a maximum 48 h. RESULTS: Levosimendan was well tolerated, with the simultaneous infusion of norepinephrine if required. Its efficacy was identical in both groups with improvement in the haemodynamic and functional status of patients (amelioration of stroke volume, cardiac index and mixed venous blood oxygen saturation, increase of left ventricular ejection fraction by echo study, de-escalation of traditional inotropes, subtraction of IABP and reduction in BNP plasma levels). The ICU stay and hospital stay were significantly decreased in patients of Group OT, compared to patients of Group ICU. Four patients died because of multiple organs dysfunction syndrome (MODS) due to sepsis (all patients of Group ICU). CONCLUSION: Levosimendan is a safe and efficient choice in the management of low-output syndrome during and after open-heart surgery. The shortening of hospitalisation and the trend for better outcome confirm its clear superiority when the infusion starts from the operating theatre.
Authors:
Androniki Tasouli; Kirillos Papadopoulos; Theophanie Antoniou; Ioannis Kriaras; Georges Stavridis; Dimitrios Degiannis; Stephanos Geroulanos
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2007-08-15
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  32     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-10     Completed Date:  2008-05-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  629-33     Citation Subset:  IM    
Affiliation:
ICU, Onassis Cardiac Surgery Center, Marathonamahon 18, 14572 Athens, Greece. atacard@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Arrhythmia Agents / administration & dosage*,  adverse effects
Cardiac Output, Low / drug therapy*
Cardiopulmonary Bypass / methods
Cardiotonic Agents / administration & dosage*,  adverse effects
Dose-Response Relationship, Drug
Female
Hemodynamics / drug effects*
Humans
Hydrazones / administration & dosage*,  adverse effects
Intraoperative Complications / drug therapy,  etiology
Male
Middle Aged
Pyridazines / administration & dosage*,  adverse effects
Syndrome
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/Cardiotonic Agents; 0/Hydrazones; 0/Pyridazines; 131741-08-7/simendan
Comments/Corrections
Erratum In:
Eur J Cardiothorac Surg. 2008 Mar;33(3):521

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


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