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Preoperative and perioperative use of levosimendan in cardiac surgery: European expert opinion.

Toller, W; Heringlake, M; Guarracino, F; Algotsson, Lars LU ; Alvarez, J; Argyriadou, H; Ben-Gal, T; Černý, V; Cholley, B and Eremenko, A, et al. (2015) In International Journal of Cardiology 184. p.323-336
Abstract
In cardiac surgery, postoperative low cardiac output has been shown to correlate with increased rates of organ failure and mortality. Catecholamines have been the standard therapy for many years, although they carry substantial risk for adverse cardiac and systemic effects, and have been reported to be associated with increased mortality. On the other hand, the calcium sensitiser and potassium channel opener levosimendan has been shown to improve cardiac function with no imbalance in oxygen consumption, and to have protective effects in other organs. Numerous clinical trials have indicated favourable cardiac and non-cardiac effects of preoperative and perioperative administration of levosimendan. A panel of 27 experts from 18 countries has... (More)
In cardiac surgery, postoperative low cardiac output has been shown to correlate with increased rates of organ failure and mortality. Catecholamines have been the standard therapy for many years, although they carry substantial risk for adverse cardiac and systemic effects, and have been reported to be associated with increased mortality. On the other hand, the calcium sensitiser and potassium channel opener levosimendan has been shown to improve cardiac function with no imbalance in oxygen consumption, and to have protective effects in other organs. Numerous clinical trials have indicated favourable cardiac and non-cardiac effects of preoperative and perioperative administration of levosimendan. A panel of 27 experts from 18 countries has now reviewed the literature on the use of levosimendan in on-pump and off-pump coronary artery bypass grafting and in heart valve surgery. This panel discussed the published evidence in these various settings, and agreed to vote on a set of questions related to the cardioprotective effects of levosimendan when administered preoperatively, with the purpose of reaching a consensus on which patients could benefit from the preoperative use of levosimendan and in which kind of procedures, and at which doses and timing should levosimendan be administered. Here, we present a systematic review of the literature to report on the completed and ongoing studies on levosimendan, including the newly commenced LEVO-CTS phase III study (NCT02025621), and on the consensus reached on the recommendations proposed for the use of preoperative levosimendan. (Less)
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International Journal of Cardiology
volume
184
pages
323 - 336
publisher
Elsevier
external identifiers
  • pmid:25734940
  • wos:000353763800069
  • scopus:84930763870
ISSN
0167-5273
DOI
10.1016/j.ijcard.2015.02.022
language
English
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yes
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2ad795de-7fba-4dfe-8463-7a9c811af836 (old id 5265418)
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http://www.ncbi.nlm.nih.gov/pubmed/25734940?dopt=Abstract
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2015-04-01 18:00:35
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2017-11-05 03:18:11
@article{2ad795de-7fba-4dfe-8463-7a9c811af836,
  abstract     = {In cardiac surgery, postoperative low cardiac output has been shown to correlate with increased rates of organ failure and mortality. Catecholamines have been the standard therapy for many years, although they carry substantial risk for adverse cardiac and systemic effects, and have been reported to be associated with increased mortality. On the other hand, the calcium sensitiser and potassium channel opener levosimendan has been shown to improve cardiac function with no imbalance in oxygen consumption, and to have protective effects in other organs. Numerous clinical trials have indicated favourable cardiac and non-cardiac effects of preoperative and perioperative administration of levosimendan. A panel of 27 experts from 18 countries has now reviewed the literature on the use of levosimendan in on-pump and off-pump coronary artery bypass grafting and in heart valve surgery. This panel discussed the published evidence in these various settings, and agreed to vote on a set of questions related to the cardioprotective effects of levosimendan when administered preoperatively, with the purpose of reaching a consensus on which patients could benefit from the preoperative use of levosimendan and in which kind of procedures, and at which doses and timing should levosimendan be administered. Here, we present a systematic review of the literature to report on the completed and ongoing studies on levosimendan, including the newly commenced LEVO-CTS phase III study (NCT02025621), and on the consensus reached on the recommendations proposed for the use of preoperative levosimendan.},
  author       = {Toller, W and Heringlake, M and Guarracino, F and Algotsson, Lars and Alvarez, J and Argyriadou, H and Ben-Gal, T and Černý, V and Cholley, B and Eremenko, A and Guerrero-Orriach, J L and Järvelä, K and Karanovic, N and Kivikko, M and Lahtinen, P and Lomivorotov, V and Mehta, R H and Mušič, Š and Pollesello, P and Rex, S and Riha, H and Rudiger, A and Salmenperä, M and Szudi, L and Tritapepe, L and Wyncoll, D and Öwall, A},
  issn         = {0167-5273},
  language     = {eng},
  pages        = {323--336},
  publisher    = {Elsevier},
  series       = {International Journal of Cardiology},
  title        = {Preoperative and perioperative use of levosimendan in cardiac surgery: European expert opinion.},
  url          = {http://dx.doi.org/10.1016/j.ijcard.2015.02.022},
  volume       = {184},
  year         = {2015},
}