Levosimendan Versus an Intra-Aortic Balloon Pump in High-Risk Cardiac Patients
Journal of Cardiothoracic and Vascular Anesthesia, 11/07/2011
Lomivorotov VV et al. – The infusion of levosimendan after anesthesia induction in cardiac surgical patients contributes to lower cardiac troponin I levels and improved hemodynamics compared with a preoperative intra-aortic balloon pump (IABP).Methods
- Ninety patients with coronary artery disease and left ventricular ejection fraction <35% who underwent surgery with cardiopulmonary bypass.
- Patients were assigned randomly to 1 of 3 groups.
- Group A received a prophylactic IABP one day before surgery.
- Group B received a prophylactic IABP one day before surgery and a levosimendan infusion at a dose of 0.1microgram/kg/min with an initial bolus (12microgram/kg for 10minutes) after anesthesia induction.
- Group C received a levosimendan infusion at a dose of 0.1microgram/kg/min with an initial bolus (12microgram/kg for 10minutes) after anesthesia induction.
- Hemodynamic and biochemical data and rate of complications were analyzed.
- The cardiac troponin I level in group C 6 hours after surgery was lower than in group A (p=0.048).
- The cardiac index in group A was significantly lower than in groups B and C.
- The intensive care unit stay was significantly shorter in group C than in groups A and B (p=0.001).
- The need for inotropic support, the rate of complications, and mortality among groups did not differ.