| Levosimendan as rescue therapy in severe cardiogenic shock after ST-elevation myocardial infarction. | |
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MedLine Citation:
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PMID: 18972629 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Data on the use of levosimendan in patients with myocardial infarction related cardiogenic shock already under combined catecholamine treatment and intra-aortic balloon counterpulsation (IABP) are scarce. Seven consecutive patients with refractory cardiogenic shock after ST-elevation myocardial infarction, multi-organ dysfunction syndrome and under maximal intensive care (combined catecholamine treatment, IABP) were treated with levosimendan (bolus 12 microg/kg i.v., thereafter 0.1 microg/kg over 24 h). Hemodynamic effects were registered invasively and monitored over 72h post infusion. Therapy with levosimendan significantly reduced required epinephrine dose after 48h (P=0.02 versus baseline). Norepinephrine dose had to be increased during the first 12 h of levosimendan (+25%; P=ns), but was significantly reduced at 72 h compared to baseline (median 0.14 versus 0.06 microg/kg/min after 72 h; P<0.05). Cardiac power output increased (baseline 0.6 versus 1.1 > or = 48 h after infusion; P<0.01) and systemic vascular resistance decreased (median 1294 dyn*s*cm-5 at baseline versus 858 dyn*s*cm-5 at 24 h; P<0.05) after levosimendan infusion. IABP therapy could be weaned in all patients during 5 days after infusion and all patients survived the cardiogenic shock (ICU mortality 29%). Levosimendan as an adjunctive, rescue therapy in patients with severe cardiogenic shock may be safe with beneficial effects on hemodynamics over 72 h. |
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Authors:
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Martin Greif; Ludwig Zwermann; Christopher Reithmann; Michael Weis |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Acute cardiac care Volume: 10 ISSN: 1748-2941 ISO Abbreviation: Acute Card Care Publication Date: 2008 |
Date Detail:
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Created Date: 2008-10-29 Completed Date: 2009-01-13 Revised Date: 2009-11-17 |
Medline Journal Info:
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Nlm Unique ID: 101276603 Medline TA: Acute Card Care Country: Sweden |
Other Details:
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Languages: eng Pagination: 185-90 Citation Subset: IM |
Affiliation:
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Medizinische Klinik und Poliklinik I, University Medical Center Munich-Grosshadern, Ludwig-Maximilians University of Munich, Munich, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiac Output Cardiotonic Agents / therapeutic use* Combined Modality Therapy Female Hemodynamics Humans Hydrazones / therapeutic use* Intra-Aortic Balloon Pumping Male Middle Aged Myocardial Infarction / complications Norepinephrine / administration & dosage Prospective Studies Pyridazines / therapeutic use* Shock, Cardiogenic / drug therapy*, etiology, physiopathology, therapy Vasoconstrictor Agents / administration & dosage Ventricular Dysfunction, Left / etiology |
| Chemical | |
Reg. No./Substance:
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0/Cardiotonic Agents; 0/Hydrazones; 0/Pyridazines; 0/Vasoconstrictor Agents; 131741-08-7/simendan; 51-41-2/Norepinephrine |
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