Levosimendan versus an intra-aortic balloon pump in high-risk cardiac patients

Vladimir V. Lomivorotov, Vladimir A. Boboshko, Sergey M. Efremov, Igor A. Kornilov, Alexandr M. Chernyavskiy, Vladimir N. Lomivorotov, Lubov G. Knazkova, Alexander M. Karaskov

    Результат исследований: Научные публикации в периодических изданияхстатья

    43 Цитирования (Scopus)

    Аннотация

    Objective: To test the hypothesis that levosimendan is more effective than intra-aortic balloon pump (IABP) support in cardiac surgical patients with low left ventricular ejection fraction to decrease cardiac troponin I levels (primary endpoint) and improve hemodynamics. Design: Prospective randomized trial. Setting: Tertiary cardiothoracic referral center. Participants: Ninety patients with coronary artery disease and left ventricular ejection fraction <35% who underwent surgery with cardiopulmonary bypass. Intervention: Patients were assigned randomly to 1 of 3 groups. Group A received a prophylactic IABP one day before surgery. Group B received a prophylactic IABP one day before surgery and a levosimendan infusion at a dose of 0.1 μg/kg/min with an initial bolus (12 μg/kg for 10 minutes) after anesthesia induction. Group C received a levosimendan infusion at a dose of 0.1 μg/kg/min with an initial bolus (12 μg/kg for 10 minutes) after anesthesia induction. Hemodynamic and biochemical data and rate of complications were analyzed. Measurements and Main Results: The cardiac troponin I level in group C 6 hours after surgery was lower than in group A (p = 0.048). The cardiac index in group A was significantly lower than in groups B and C. The intensive care unit stay was significantly shorter in group C than in groups A and B (p = 0.001). The need for inotropic support, the rate of complications, and mortality among groups did not differ. Conclusions: The infusion of levosimendan after anesthesia induction in cardiac surgical patients contributes to lower cardiac troponin I levels and improved hemodynamics compared with a preoperative IABP.

    Язык оригиналаанглийский
    Страницы (с-по)596-603
    Число страниц8
    ЖурналJournal of Cardiothoracic and Vascular Anesthesia
    Том26
    Номер выпуска4
    DOI
    СостояниеОпубликовано - 1 авг 2012

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    Предметные области Scopus

    • Кардиология и сердечно-сосудистая медицина
    • Анестезиология

    Цитировать

    Lomivorotov, V. V., Boboshko, V. A., Efremov, S. M., Kornilov, I. A., Chernyavskiy, A. M., Lomivorotov, V. N., ... Karaskov, A. M. (2012). Levosimendan versus an intra-aortic balloon pump in high-risk cardiac patients. Journal of Cardiothoracic and Vascular Anesthesia, 26(4), 596-603. https://doi.org/10.1053/j.jvca.2011.09.006