Levosimendan: A retrospective single-center case series

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), 1075-1078. (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.

This record has no associated files available for download.

Contributors

Author: C.A. Mckenzie

Download statistics