Key result
IV levosimendan improves hemodynamics vs dobutamine but does not reduce 28-day ICU mortality.
Why the study?
Critically ill patients with left ventricular failure and systemic hypoperfusion require inotropic agents to maintain hemodynamics, but the comparative efficacy and safety of levosimendan versus dobutamine needed evaluation.
Does intravenous Levosimendan improve hemodynamics and mortality compared to intravenous Dobutamine in critically ill patients with Left Ventricular Failure?
RCT (n=60)
Double-blind
No
Does intravenous Levosimendan improve hemodynamics and mortality compared to intravenous Dobutamine in critically ill patients with Left Ventricular Failure?
In critically ill patients with left ventricular failure, levosimendan provides superior hemodynamic improvement compared to dobutamine, though without a significant difference in 28-day mortality.
May favor levosimendan for hemodynamic support in ICU LV failure; extends small RCT data on surrogates without clarifying mortality.
Background: Heart failure is a life-threatening complication encountered in ICU. Severe left ventricular (LV) dysfunction is associated with significant morbidity and mortality. For critically ill patients with LVF and systemic hypoperfusion, for maintenance of hemodynamic parameters inotropic agents are required.Aim of The Work: To evaluate and compare the efficacy and safety of intravenous Levosimendan and intravenous Dobutamine in critically ill patients with Left Ventricular Failure.Materials and Methods: This double-blind randomized prospective interventional study was carried out on 60 adult patients in the Intensive Care Unit, Sir Sunderlal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi. Patients were randomly allocated to 2 groups of 30 patients each; Group A received Levosimendan and Group B received Dobutamine. Hemodynamic variables systolic and diastolic blood pressure (SBP & DBP), mean arterial pressure (MAP), heart rate, serum lactate, serum creatinine, 24 hour urine output and 28 day ICU mortality were investigated. Results: The group treated with Levosimendan showed significant improvement in SBP, DBP and MAP along with lesser increase in HR; indicating a better improvement in cardiac contractility; as compared to Dobutamine, We also observed increase in serum lactate levels in the patients treated with Dobutamine. No significant difference reported among the groups regarding treatment related adverse effects and over-all 28 day ICU mortality.Conclusion: We conclude that use of levosimendan is superior to dobutamine in terms of improvement in hemodynamic parameters in patients with Left Ventricular failure. However we couldn’t find any significant improvement in mortality on use of levosimendan over dobutamine.
No takes yet. Share an insight, caveat, or question.
Anand et al. (2025) conducted an RCT in Left Ventricular Failure (n=60). Levosimendan vs. Dobutamine was evaluated on Hemodynamic variables (SBP, DBP, MAP, HR), serum lactate, serum creatinine, 24 hour urine output and 28 day ICU mortality. In 60 critically ill patients, intravenous levosimendan was superior to dobutamine for improving hemodynamic parameters, with no significant difference in 28-day ICU mortality.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: