AIMS AND OBJECTIVES: We aimed to compare the hemodynamic effects of levosimendan and dobutamine in patients undergoing mitral valve surgery on cardiopulmonary bypass (CPB). MATERIALS AND METHODS:Sixty patients were divided into 2 groups of 30 each. Group-L patients received levosimendan 0.1 μg/kg/min and Group-D patients received dobutamine 5 μg/kg/min while weaning off CPB. Additional inotrope and/or vasoconstrictor were started based on hemodynamic parameters. Hemodynamic data were collected at the end and at 30 minutes after CPB, thereafter at 6, 12, 24, and 36 hours post-CPB. Mean arterial pressure (MAP), central venous pressure (CVP), heart rate (HR), cardiac index (CI), systemic vascular resistance index (SVRI), and lactate levels were measured. RESULTS: Group-L showed increased requirement of inotropes and vasoconstrictors. The SVRI, CVP, and MAP were reduced more in Group-L. The CI was low in Group-L in the initial period when compared to Group-D. Later Group-L patients showed a statistically significant increase in CI even after 12 hrs of discontinuation of levosimendan infusion. The HR was increased more in Group-D. Lactate levels, intensive care unit stay, and duration of ventilation were similar in both groups. CONCLUSIONS:Levosimendan 0.1 μg/kg/min compared to dobutamine 5 μg/kg/min showed more vasodilation and lesser inotropic activity in patients undergoing mitral valve surgery for mitral stenosis. Levosimendan compared to dobutamine showed a statistically significant increase in CI even after 12 hrs of discontinuation. The requirement of another inotrope or vasopressor was frequent in levosimendan group.
RCT Entities:
AIMS AND OBJECTIVES: We aimed to compare the hemodynamic effects of levosimendan and dobutamine in patients undergoing mitral valve surgery on cardiopulmonary bypass (CPB). MATERIALS AND METHODS: Sixty patients were divided into 2 groups of 30 each. Group-L patients received levosimendan 0.1 μg/kg/min and Group-D patients received dobutamine 5 μg/kg/min while weaning off CPB. Additional inotrope and/or vasoconstrictor were started based on hemodynamic parameters. Hemodynamic data were collected at the end and at 30 minutes after CPB, thereafter at 6, 12, 24, and 36 hours post-CPB. Mean arterial pressure (MAP), central venous pressure (CVP), heart rate (HR), cardiac index (CI), systemic vascular resistance index (SVRI), and lactate levels were measured. RESULTS: Group-L showed increased requirement of inotropes and vasoconstrictors. The SVRI, CVP, and MAP were reduced more in Group-L. The CI was low in Group-L in the initial period when compared to Group-D. Later Group-L patients showed a statistically significant increase in CI even after 12 hrs of discontinuation of levosimendan infusion. The HR was increased more in Group-D. Lactate levels, intensive care unit stay, and duration of ventilation were similar in both groups. CONCLUSIONS:Levosimendan 0.1 μg/kg/min compared to dobutamine 5 μg/kg/min showed more vasodilation and lesser inotropic activity in patients undergoing mitral valve surgery for mitral stenosis. Levosimendan compared to dobutamine showed a statistically significant increase in CI even after 12 hrs of discontinuation. The requirement of another inotrope or vasopressor was frequent in levosimendan group.
Authors: Jose L Guerrero-Orriach; Alfredo Malo-Manso; Marta Ramirez-Aliaga; Ana Isabel Florez Vela; Manuel Galán-Ortega; Isabel Moreno-Cortes; Inmaculada Gonzalez-Almendros; Alicia Ramirez-Fernandez; Daniel Ariza-Villanueva; Juan Jose Escalona-Belmonte; Guillermo Quesada-Muñoz; Enrique Sepúlveda-Haro; Salvador Romero-Molina; Inmaculada Bellido-Estevez; Aurelio Gomez-Luque; Manuel Rubio-Navarro; Juan Alcaide-Torres; Concepcion Santiago-Fernandez; Lourdes Garrido-Sanchez; Jose Cruz-Mañas Journal: Front Pharmacol Date: 2020-08-26 Impact factor: 5.810
Authors: Victor H Nieto Estrada; Daniel L Molano Franco; Albert A Valencia Moreno; Jose A Rojas Gambasica; Cristian C Cortes Nunez Journal: Cardiol Res Date: 2016-12-31
Authors: Andres Beiras-Fernandez; Angela Kornberger; Martin Oberhoffer; Felix Kur; Marion Weis; Christian-Friedrich Vahl; Florian Weis Journal: J Int Med Res Date: 2019-03-26 Impact factor: 1.671