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Impact of levosimendan on weaning from peripheral venoarterial extracorporeal membrane oxygenation in intensive care unit

BACKGROUND: Few data are available on the impact of levosimendan in refractory cardiogenic shock patients undergoing peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO). The aim of this study was to evaluate the impact of levosimendan on VA-ECMO weaning in patients hospitalized in...

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Autores principales: Vally, Shamir, Ferdynus, Cyril, Persichini, Romain, Bouchet, Bruno, Braunberger, Eric, Lo Pinto, Hugo, Martinet, Olivier, Vandroux, David, Aujoulat, Thomas, Allyn, Jérôme, Allou, Nicolas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6358626/
https://www.ncbi.nlm.nih.gov/pubmed/30707314
http://dx.doi.org/10.1186/s13613-019-0503-1
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author Vally, Shamir
Ferdynus, Cyril
Persichini, Romain
Bouchet, Bruno
Braunberger, Eric
Lo Pinto, Hugo
Martinet, Olivier
Vandroux, David
Aujoulat, Thomas
Allyn, Jérôme
Allou, Nicolas
author_facet Vally, Shamir
Ferdynus, Cyril
Persichini, Romain
Bouchet, Bruno
Braunberger, Eric
Lo Pinto, Hugo
Martinet, Olivier
Vandroux, David
Aujoulat, Thomas
Allyn, Jérôme
Allou, Nicolas
author_sort Vally, Shamir
collection PubMed
description BACKGROUND: Few data are available on the impact of levosimendan in refractory cardiogenic shock patients undergoing peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO). The aim of this study was to evaluate the impact of levosimendan on VA-ECMO weaning in patients hospitalized in intensive care unit (ICU). METHODS: This retrospective cohort study was conducted in a French university hospital from 2010 to 2017. All patients hospitalized in ICU undergoing VA-ECMO were consecutively evaluated. RESULTS: A total of 150 patients undergoing VA-ECMO were eligible for the study. Thirty-eight propensity-matched patients were evaluated in the levosimendan group and 65 in the non-levosimendan group. In patients treated with levosimendan, left ventricular ejection fraction had increased from 21.5 ± 9.1% to 30.7 ± 13.5% (P < 0.0001) and aortic velocity–time integral from 8.9 ± 4 cm to 12.5 ± 3.8 cm (P = 0.002) 24 h after drug infusion. After propensity score matching, levosimendan was the only factor associated with a significant reduction in VA-ECMO weaning failure rates (hazard ratio = 0.16; 95% confidence interval 0.04–0.7; P = 0.01). Kaplan–Meier survival curves showed that survival rates at 30 days were 78.4% for the levosimendan group and 49.5% for the non-levosimendan group (P = 0.02). After propensity score matching analysis, the difference in 30-day mortality between the two groups was not significant (hazard ratio = 0.55; 95% confidence interval 0.27–1.10; P = 0.09). CONCLUSIONS: Our results suggest that levosimendan was associated with a beneficial effect on VA-ECMO weaning in ICU patients.
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spelling pubmed-63586262019-02-24 Impact of levosimendan on weaning from peripheral venoarterial extracorporeal membrane oxygenation in intensive care unit Vally, Shamir Ferdynus, Cyril Persichini, Romain Bouchet, Bruno Braunberger, Eric Lo Pinto, Hugo Martinet, Olivier Vandroux, David Aujoulat, Thomas Allyn, Jérôme Allou, Nicolas Ann Intensive Care Research BACKGROUND: Few data are available on the impact of levosimendan in refractory cardiogenic shock patients undergoing peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO). The aim of this study was to evaluate the impact of levosimendan on VA-ECMO weaning in patients hospitalized in intensive care unit (ICU). METHODS: This retrospective cohort study was conducted in a French university hospital from 2010 to 2017. All patients hospitalized in ICU undergoing VA-ECMO were consecutively evaluated. RESULTS: A total of 150 patients undergoing VA-ECMO were eligible for the study. Thirty-eight propensity-matched patients were evaluated in the levosimendan group and 65 in the non-levosimendan group. In patients treated with levosimendan, left ventricular ejection fraction had increased from 21.5 ± 9.1% to 30.7 ± 13.5% (P < 0.0001) and aortic velocity–time integral from 8.9 ± 4 cm to 12.5 ± 3.8 cm (P = 0.002) 24 h after drug infusion. After propensity score matching, levosimendan was the only factor associated with a significant reduction in VA-ECMO weaning failure rates (hazard ratio = 0.16; 95% confidence interval 0.04–0.7; P = 0.01). Kaplan–Meier survival curves showed that survival rates at 30 days were 78.4% for the levosimendan group and 49.5% for the non-levosimendan group (P = 0.02). After propensity score matching analysis, the difference in 30-day mortality between the two groups was not significant (hazard ratio = 0.55; 95% confidence interval 0.27–1.10; P = 0.09). CONCLUSIONS: Our results suggest that levosimendan was associated with a beneficial effect on VA-ECMO weaning in ICU patients. Springer International Publishing 2019-02-01 /pmc/articles/PMC6358626/ /pubmed/30707314 http://dx.doi.org/10.1186/s13613-019-0503-1 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Research
Vally, Shamir
Ferdynus, Cyril
Persichini, Romain
Bouchet, Bruno
Braunberger, Eric
Lo Pinto, Hugo
Martinet, Olivier
Vandroux, David
Aujoulat, Thomas
Allyn, Jérôme
Allou, Nicolas
Impact of levosimendan on weaning from peripheral venoarterial extracorporeal membrane oxygenation in intensive care unit
title Impact of levosimendan on weaning from peripheral venoarterial extracorporeal membrane oxygenation in intensive care unit
title_full Impact of levosimendan on weaning from peripheral venoarterial extracorporeal membrane oxygenation in intensive care unit
title_fullStr Impact of levosimendan on weaning from peripheral venoarterial extracorporeal membrane oxygenation in intensive care unit
title_full_unstemmed Impact of levosimendan on weaning from peripheral venoarterial extracorporeal membrane oxygenation in intensive care unit
title_short Impact of levosimendan on weaning from peripheral venoarterial extracorporeal membrane oxygenation in intensive care unit
title_sort impact of levosimendan on weaning from peripheral venoarterial extracorporeal membrane oxygenation in intensive care unit
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6358626/
https://www.ncbi.nlm.nih.gov/pubmed/30707314
http://dx.doi.org/10.1186/s13613-019-0503-1
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