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Prophylactic preoperative levosimendan administration in heart failure patients undergoing elective non-cardiac surgery: A preliminary report
The Hellenic Journal of Cardiology, 06/09/09

Katsaragakis S et al. – Prophylactic preoperative levosimendan treatment may be safe and efficient for the perioperative optimization of heart failure pts undergoing non-cardiac surgery.

Methods

Prospective study of the safety and efficacy of prophylactic preoperative levosimendan administration in cardiac failure (CF) pts
CF pts with ejection fraction <35% undergoing elective non-cardiac (abdominal) surgery during 6-mo-period
All surgical intensive care unit pts 1 day preoperatively for levosimendan administration, received a bolus infusion (2.4 Ig/kg) for 10 min, then 24-hr continuous infusion (0.1 Ig/kg/min), then surgery
Continuous hemodynamic monitoring in SICU during levosimendan infusion and for 24 hr post-infusion
Recording of hemodynamic parameters (heart rate, arterial pressure, pulmonary artery catheter data) before treatment, 10 min after drug initiation, and at 3-hr intervals to 24 hr post-infusion
Echocardiography before infusion and on 7th post-infusion day

Results

Total of 9 pts enrolled
Cardiac index and stroke volume index increased significantly at 24 hr after drug initiation and remained increased for 24 hr post-infusion
Systemic vascular resistance index decreased at 10 min and remained reduced during whole observation period
Ejection fraction significantly increased on 7th post-infusion day
No adverse reactions, complications or deaths occurred during 30 days' follow up