Universität zu Köln

Weber, Carolyn, Esser, Matthias, Eghbalzadeh, Kaveh, Sabashnikov, Anton ORCID: 0000-0002-6289-1035, Djordjevic, Ilija ORCID: 0000-0002-5810-8626, Maier, Johanna, Merkle, Julia, Choi, Yeong-Hoon, Madershahian, Navid, Liakopoulos, Oliver, Deppe, Antje Christin and Wahlers, Thorsten C. W. (2020). Levosimendan Reduces Mortality and Low Cardiac Output Syndrome in Cardiac Surgery. Thorac. Cardiovasc. Surg., 68 (5). S. 401 - 410. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-1902

Full text not available from this repository.

Abstract

Background There has been conflicting evidence concerning the effect of levosimendan on clinical outcomes in patients undergoing cardiac surgery. Therefore, we performed a systematic review and conducted this meta-analysis to provide evidence for/against the administration of levosimendan in cardiac surgery patients. Methods We performed a meta-analysis from literature search in PubMed, EMBASE, and Cochrane Library. Only randomized controlled trials comparing the administration of levosimendan in cardiac surgery patients with a control group (other inotrope, standard therapy/placebo, or an intra-aortic balloon pump) were included. In addition, at least one clinical outcome had to be mentioned: mortality, myocardial infarction, low cardiac output syndrome (LCOS), acute kidney injury, renal replacement therapy, atrial fibrillation, prolonged inotropic support, length of intensive care unit, and hospital stay. The pooled treatment effects (odds ratio [OR], 95% confidence intervals [CI]) were assessed using a fixed or random effects model. Results The literature search retrieved 27 randomized, controlled trials involving a total of 3,198 patients. Levosimendan led to a significant reduction in mortality (OR: 0.67; 95% CI: 0.49-0.91;p = 0.0087). Furthermore, the incidence of LCOS (OR: 0.56, 95% CI: 0.42-0.75;p < 0.0001), acute kidney injury (OR: 0.63; 95% CI: 0.46-0.86;p = 0.0039), and renal replacement therapy (OR: 0.70; 95% CI: 0.50-0.98;p = 0.0332) was significantly decreased in the levosimendan group. Conclusion Our meta-analysis suggests beneficial effects for the prophylactic use of levosimendan in patients with severely impaired left ventricular function undergoing cardiac surgery. The administration of levosimendan was associated with a reduced mortality, less LCOS, and restored adequate organ perfusion reflected in less acute kidney injury.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Weber, Carolyn UNSPECIFIED UNSPECIFIED UNSPECIFIED Esser, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Eghbalzadeh, Kaveh UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabashnikov, Anton UNSPECIFIED orcid.org/0000-0002-6289-1035 UNSPECIFIED Djordjevic, Ilija UNSPECIFIED orcid.org/0000-0002-5810-8626 UNSPECIFIED Maier, Johanna UNSPECIFIED UNSPECIFIED UNSPECIFIED Merkle, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Choi, Yeong-Hoon UNSPECIFIED UNSPECIFIED UNSPECIFIED Madershahian, Navid UNSPECIFIED UNSPECIFIED UNSPECIFIED Liakopoulos, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Deppe, Antje Christin UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten C. W. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-325065
DOI:	10.1055/s-0039-3400496
Journal or Publication Title:	Thorac. Cardiovasc. Surg.
Volume:	68
Number:	5
Page Range:	S. 401 - 410
Date:	2020
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1439-1902
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LEFT-VENTRICULAR DYSFUNCTION; LOW EJECTION FRACTION; AORTIC-VALVE; CARDIOPULMONARY BYPASS; PERIOPERATIVE USE; BLOOD-FLOW; PUMP; DOBUTAMINE; INFUSION; METAANALYSIS Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/32506