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Overview of the current use of levosimendan in France: a prospective observational cohort study

BACKGROUND: Following the results of randomized controlled trials on levosimendan, French health authorities requested an update of the current use and side-effects of this medication on a national scale. METHOD: The France-LEVO registry was a prospective observational cohort study reflecting the in...

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Detalles Bibliográficos
Autores principales: Cholley, Bernard, Bojan, Mirela, Guillon, Benoit, Besnier, Emmanuel, Mattei, Mathieu, Levy, Bruno, Ouattara, Alexandre, Tafer, Nadir, Delmas, Clément, Tonon, David, Rozec, Bertrand, Fellahi, Jean-Luc, Lim, Pascal, Labaste, François, Roubille, François, Caruba, Thibaut, Mauriat, Philippe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10409690/
https://www.ncbi.nlm.nih.gov/pubmed/37552372
http://dx.doi.org/10.1186/s13613-023-01164-3
Descripción
Sumario:BACKGROUND: Following the results of randomized controlled trials on levosimendan, French health authorities requested an update of the current use and side-effects of this medication on a national scale. METHOD: The France-LEVO registry was a prospective observational cohort study reflecting the indications, dosing regimens, and side-effects of levosimendan, as well as patient outcomes over a year. RESULTS: The patients included (n = 602) represented 29.6% of the national yearly use of levosimendan in France. They were treated for cardiogenic shock (n = 250, 41.5%), decompensated heart failure (n = 127, 21.1%), cardiac surgery-related low cardiac output prophylaxis and/or treatment (n = 86, 14.3%), and weaning from veno-arterial extracorporeal membrane oxygenation (n = 82, 13.6%). They received 0.18 ± 0.07 µg/kg/min levosimendan over 26 ± 8 h. An initial bolus was administered in 45 patients (7.5%), 103 (17.1%) received repeated infusions, and 461 (76.6%) received inotropes and or vasoactive agents concomitantly. Hypotension was reported in 218 patients (36.2%), atrial fibrillation in 85 (14.1%), and serious adverse events in 17 (2.8%). 136 patients (22.6%) died in hospital, and 26 (4.3%) during the 90-day follow-up. CONCLUSIONS: We observed that levosimendan was used in accordance with recent recommendations by French physicians. Hypotension and atrial fibrillation remained the most frequent side-effects, while serious adverse event potentially attributable to levosimendan were infrequent. The results suggest that this medication was safe and potentially associated with some benefit in the population studied. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13613-023-01164-3.