Levosimendan: A retrospective single-center case series
Levosimendan: A retrospective single-center case series
Purpose
The purpose of this study is to describe the effect of levosimendan (without loading dose) on hemodynamics, inotropes/vasopressors, and mortality in acute heart failure (AHF).
Materials and Methods
Patients who received levosimendan for AHF were analyzed. Levosimendan dose, hemodynamic data, inotrope/vasopressor requirements, and fluid balance before commencement, at conclusion of, and 24 hours after levosimendan were collected. Mortality is also reported.
Results
Eighty-seven patients were analyzed. The mean levosimendan dose (without loading) was 0.096 μg/kg per minute (± 0.014), and mean duration, 26 (± 7.2) hours. There was no change in heart rate (start, post, and 24 hours post) (92 [± 19], 92 [± 26], and 92 [± 15]) or mean arterial pressure (69 [± 10], 72 [± 8], and 72 [± 10] mm Hg, respectively). There was a significant reduction in median dobutamine from 7.27 to 0 μg/kg per minute and noradrenaline from 0.20 to 0.1 μg/kg per minute before and 24 hours after. There was a significant increase in both mean cardiac index from 2.38 ± 0.0.72 to 2.98 ± 0.0.77 L/min per square meter and in markers of perfusion: base excess from − 2.77 to 0.39 mmol/L, and lactate from 2.1 to 1.4 mmol/L before and 24 hours after infusion. Survival was 53%.
Conclusions
Levosimendan, without a loading dose, improved cardiac index and perfusion while allowing a reduction in inotropic/vasopressor requirements in patients with AHF.
1075-1078
Berry, W.T.
51b5b797-5eae-4b10-ab4b-69eb6f4bf1e6
Hewson, R.W.
6f66f383-75d7-4182-8e57-60cf716f6a28
Langrish, C.J.
afd29422-1221-434d-bd64-f156b5ac1e63
Mckenzie, C.A.
ec344dee-5777-49c5-970e-6326e82c9f8c
Barrett, N.A.
5b41605f-b726-436b-8283-280e5f1400a1
30 August 2013
Berry, W.T.
51b5b797-5eae-4b10-ab4b-69eb6f4bf1e6
Hewson, R.W.
6f66f383-75d7-4182-8e57-60cf716f6a28
Langrish, C.J.
afd29422-1221-434d-bd64-f156b5ac1e63
Mckenzie, C.A.
ec344dee-5777-49c5-970e-6326e82c9f8c
Barrett, N.A.
5b41605f-b726-436b-8283-280e5f1400a1
Berry, W.T., Hewson, R.W., Langrish, C.J., Mckenzie, C.A. and Barrett, N.A.
(2013)
Levosimendan: A retrospective single-center case series.
Journal of Critical Care, 28 (6), .
(doi:10.1016/j.jcrc.2013.06.014).
Abstract
Purpose
The purpose of this study is to describe the effect of levosimendan (without loading dose) on hemodynamics, inotropes/vasopressors, and mortality in acute heart failure (AHF).
Materials and Methods
Patients who received levosimendan for AHF were analyzed. Levosimendan dose, hemodynamic data, inotrope/vasopressor requirements, and fluid balance before commencement, at conclusion of, and 24 hours after levosimendan were collected. Mortality is also reported.
Results
Eighty-seven patients were analyzed. The mean levosimendan dose (without loading) was 0.096 μg/kg per minute (± 0.014), and mean duration, 26 (± 7.2) hours. There was no change in heart rate (start, post, and 24 hours post) (92 [± 19], 92 [± 26], and 92 [± 15]) or mean arterial pressure (69 [± 10], 72 [± 8], and 72 [± 10] mm Hg, respectively). There was a significant reduction in median dobutamine from 7.27 to 0 μg/kg per minute and noradrenaline from 0.20 to 0.1 μg/kg per minute before and 24 hours after. There was a significant increase in both mean cardiac index from 2.38 ± 0.0.72 to 2.98 ± 0.0.77 L/min per square meter and in markers of perfusion: base excess from − 2.77 to 0.39 mmol/L, and lactate from 2.1 to 1.4 mmol/L before and 24 hours after infusion. Survival was 53%.
Conclusions
Levosimendan, without a loading dose, improved cardiac index and perfusion while allowing a reduction in inotropic/vasopressor requirements in patients with AHF.
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More information
Published date: 30 August 2013
Identifiers
Local EPrints ID: 479625
URI: http://eprints.soton.ac.uk/id/eprint/479625
ISSN: 0883-9441
PURE UUID: 25a24652-9586-43be-ac6b-0283896e392c
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Date deposited: 26 Jul 2023 16:42
Last modified: 17 Mar 2024 04:23
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Contributors
Author:
W.T. Berry
Author:
R.W. Hewson
Author:
C.J. Langrish
Author:
C.A. Mckenzie
Author:
N.A. Barrett
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