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Efficacy of Levosimendan in the Treatment of Patients with Severe Septic Cardiomyopathy

Published:November 05, 2022DOI:https://doi.org/10.1053/j.jvca.2022.10.032

      Abstract

      Objective

      This study was designed to compare the effects of levosimendan and dobutamine on hemodynamics and clinical efficacy in patients with severe septic cardiomyopathy (left ventricular ejection fraction [LVEF] ≤35%).

      Design

      Prospective, single-blind, randomized controlled study.

      Setting

      Baoding, China.

      Participants

      Thirty patients with severe septic cardiomyopathy treated in our hospital's Department of Critical Medicine from September 2018 to September 2021 were enrolled into this study.

      Interventions

      These patients were randomly divided into the levosimendan group and dobutamine group. LVEF, cardiac index (CI), stroke volume index (SVI), systemic vascular resistance index (SVRI), heart rate (HR), norepinephrine dose (NED), and lactate (Lac) at the time of enrollment and the 24th hour were compared, along with myocardial injury markers on the third day, C-reactive protein (CRP), mechanical ventilation time, length of intensive care unit (ICU) stay, cost, and 28-day mortality. The primary outcome was 28-day mortality.

      Measurements & Main Results

      At the 24th hour after treatment, the CI, LVEF, SVI, and fluid volume were found to be higher in the levosimendan group than in the dobutamine group, while the dose of norepinephrine was lower in the former than the latter group. On the third day of treatment, cardiac troponin I (cTnI) in the levosimendan group was lower than that in the dobutamine group. While the differences in 28-day mortality, ICU stay, and ICU treatment cost between the two groups were not statistically significant, the ventilator application time of the levosimendan group was significantly shorter than that of the dobutamine group.

      Conclusions

      Compared with dobutamine, levosimendan is more effective at improving cardiac function, reducing myocardial injury, and reducing mechanical ventilation time in patients with severe septic cardiomyopathy.

      Keywords

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