HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Corrigendum (v33,p522) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Stephanos Geroulanos Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tasouli, A. Articles by Geroulanos, S. Search for Related Content PubMed PubMed Citation Articles by Tasouli, A. Articles by Geroulanos, S. Related Collections Cardiac - pharmacology Extracorporeal circulation Myocardial protection

Eur J Cardiothorac Surg 2007;32:629-633. doi:10.1016/j.ejcts.2007.07.010
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Efficacy and safety of perioperative infusion of levosimendan in patients with compromised cardiac function undergoing open-heart surgery: importance of early use

^a ICU, Onassis Cardiac Surgery Center, Athens, Greece
^b Department of Anaesthesiology, Onassis Cardiac Surgery Center, Athens, Greece
^c 1st Department of Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece
^d Department of Immunopathology & Histocompatibility, Onassis Cardiac Surgery Center, Athens, Greece

Received 10 April 2007; received in revised form 6 July 2007; accepted 9 July 2007.

^_* Corresponding author. Address: Marathonomahon 18, 14572 Athens, Greece. Tel.: +30 210 8133257. (Email: atacard{at}hotmail.com).

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 µg/kg min without loading dose, the infusion being for at least 24 h 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.

Key Words: Levosimendan • Perioperative infusion • Open-heart surgery • Low-output syndrome

This article has been cited by other articles:

				Y. Zhang and T. N. Mazgalev Cardiac vagal stimulation eliminates detrimental tachycardia effects of dobutamine used for inotropic support. Ann. Thorac. Surg., July 1, 2009; 88(1): 117 - 122. [Abstract] [Full Text] [PDF]

				T. Vanek, M. Kolesar, M. Nejedly, and R. Jirmar Rescue peri-operative management of the patient with giant electrical storm and severe left ventricular dysfunction: support by levosimendan and intraaortic balloon counterpulsation Interactive CardioVascular and Thoracic Surgery, August 1, 2008; 7(4): 648 - 650. [Abstract] [Full Text] [PDF]