Zhao-Zhuo Niu1, Shu-Ming Wu, Wen-Yu Sun, Wen-Ming Hou, Yi-Fan Chi. 1. *Department of Cardiac Surgery, Qilu Hospital, Shandong University, Jinnan, China; and †Department of Cardiac Surgery, Qingdao Municipal Hospital, Qingdao, China.
Abstract
OBJECTIVE: Levosimendan is a calcium sensitizer that enhances myocardial contractility without increasing myocardial oxygen use. Limited data are available on its renal-protective effect, and no statistically significant effects have been found. A meta-analysis was conducted for randomized studies to show whether perioperative levosimendan use could reduce acute kidney injury (AKI) in patients undergoing cardiac surgery. DATA SOURCES: BioMed Central, PubMed EMBASE, and the Cochrane Central Register of Controlled Trials were searched for pertinent studies. STUDY SELECTION: Randomized trials that compared levosimendan versus placebo or any other control in cardiac surgery with data on AKI were included. Exclusion criteria were duplicate publications, nonadult studies, oral administration of levosimendan, and studies with no data on AKI. DATA EXTRACTION: Study endpoints, study design, population, clinical setting, levosimendan dosage, and treatment duration were extracted. DATA SYNTHESIS: Data from 529 patients in 5 randomized trials were analyzed. The analysis showed that levosimendan decreased postoperative incidence of AKI in the levosimendan group. CONCLUSIONS: This analysis suggests that levosimendan might reduce renal injury in adult patients undergoing cardiac surgery. More prospective randomized studies are needed to further demonstrate the benefits of levosimendan on renal protection in cardiac surgery.
OBJECTIVE:Levosimendan is a calcium sensitizer that enhances myocardial contractility without increasing myocardial oxygen use. Limited data are available on its renal-protective effect, and no statistically significant effects have been found. A meta-analysis was conducted for randomized studies to show whether perioperative levosimendan use could reduce acute kidney injury (AKI) in patients undergoing cardiac surgery. DATA SOURCES: BioMed Central, PubMed EMBASE, and the Cochrane Central Register of Controlled Trials were searched for pertinent studies. STUDY SELECTION: Randomized trials that compared levosimendan versus placebo or any other control in cardiac surgery with data on AKI were included. Exclusion criteria were duplicate publications, nonadult studies, oral administration of levosimendan, and studies with no data on AKI. DATA EXTRACTION: Study endpoints, study design, population, clinical setting, levosimendan dosage, and treatment duration were extracted. DATA SYNTHESIS: Data from 529 patients in 5 randomized trials were analyzed. The analysis showed that levosimendan decreased postoperative incidence of AKI in the levosimendan group. CONCLUSIONS: This analysis suggests that levosimendan might reduce renal injury in adult patients undergoing cardiac surgery. More prospective randomized studies are needed to further demonstrate the benefits of levosimendan on renal protection in cardiac surgery.
Authors: Zoltán Papp; Piergiuseppe Agostoni; Julian Alvarez; Dominique Bettex; Stefan Bouchez; Dulce Brito; Vladimir Černý; Josep Comin-Colet; Marisa G Crespo-Leiro; Juan F Delgado; István Édes; Alexander A Eremenko; Dimitrios Farmakis; Francesco Fedele; Cândida Fonseca; Sonja Fruhwald; Massimo Girardis; Fabio Guarracino; Veli-Pekka Harjola; Matthias Heringlake; Antoine Herpain; Leo M A Heunks; Tryggve Husebye; Višnja Ivancan; Kristjan Karason; Sundeep Kaul; Matti Kivikko; Janek Kubica; Josep Masip; Simon Matskeplishvili; Alexandre Mebazaa; Markku S Nieminen; Fabrizio Oliva; Julius G Papp; John Parissis; Alexander Parkhomenko; Pentti Põder; Gerhard Pölzl; Alexander Reinecke; Sven-Erik Ricksten; Hynek Riha; Alain Rudiger; Toni Sarapohja; Robert H G Schwinger; Wolfgang Toller; Luigi Tritapepe; Carsten Tschöpe; Gerhard Wikström; Dirk von Lewinski; Bojan Vrtovec; Piero Pollesello Journal: J Cardiovasc Pharmacol Date: 2020-07 Impact factor: 3.105
Authors: Zoltán Papp; Piergiuseppe Agostoni; Julian Alvarez; Dominique Bettex; Stefan Bouchez; Dulce Brito; Vladimir Černý; Josep Comin-Colet; Marisa G Crespo-Leiro; Juan F Delgado; Istvan Édes; Alexander A Eremenko; Dimitrios Farmakis; Francesco Fedele; Cândida Fonseca; Sonja Fruhwald; Massimo Girardis; Fabio Guarracino; Veli-Pekka Harjola; Matthias Heringlake; Antoine Herpain; Leo Ma Heunks; Tryggve Husebye; Višnja Ivancan; Kristjan Karason; Sundeep Kaul; Matti Kivikko; Janek Kubica; Josep Masip; Simon Matskeplishvili; Alexandre Mebazaa; Markku S Nieminen; Fabrizio Oliva; Julius-Gyula Papp; John Parissis; Alexander Parkhomenko; Pentti Põder; Gerhard Pölzl; Alexander Reinecke; Sven-Erik Ricksten; Hynek Riha; Alain Rudiger; Toni Sarapohja; Robert Hg Schwinger; Wolfgang Toller; Luigi Tritapepe; Carsten Tschöpe; Gerhard Wikström; Dirk von Lewinski; Bojan Vrtovec; Piero Pollesello Journal: Card Fail Rev Date: 2020-07-08