Key result
Levosimendan administration immediately after heart valve replacement improved left ventricular ejection fraction at 7 days and reduced ICU length of stay compared to placebo.
Why the study?
The study was conducted to explore the effect of levosimendan in patients after heart valve replacement and its influence on postoperative recovery.
Does levosimendan intravenous infusion improve heart function and postoperative recovery in patients undergoing conventional heart valve replacement?
RCT (n=185)
Placebo-controlled
Random number table
No
Does levosimendan intravenous infusion improve heart function and postoperative recovery in patients undergoing conventional heart valve replacement?
Answers are grounded in this paper and cite their sources.
Levosimendan administered immediately after conventional heart valve replacement improves postoperative hemodynamics, reduces the need for vasoactive drugs, and shortens ICU length of stay.
BACKGROUND The aim of this study was to explore the effect of levosimendan in patients after heart valve replacement and its influence on postoperative recovery. MATERIAL AND METHODS This prospective study included 185 patients with valvular diseases undergoing conventional valve replacement. Patients were divided into 2 groups using a random number table before surgery. Patients in the levosimendan group were administrated levosimendan intravenous infusion immediately after entering the Intensive Care Unit (ICU). The left ventricular ejection fraction (LVEF), cardiac output, and heart failure-related index, such as B-type natriuretic peptide (BNP) level, were recorded at 1, 3, and 7 days after surgery. The dosage and administration time of dopamine and epinephrine, mechanical ventilation time, ICU length of stay, and postoperative adverse events were recorded. RESULTS Cardiac output and LVEF of patients in the levosimendan group were significantly higher than those in the control group at different time points (P<0.05), and BNP level was lower than that of the control group (P<0.0001). Dosage and administration time of dopamine and epinephrine in the levosimendan group were lower than those of the control group (P<0.0001, P<0.0001, respectively). ICU length of stay and total incidence of postoperative adverse events were lower than those of the control group (P<0.0001, P=0.002, respectively). CONCLUSIONS Levosimendan administration immediately after heart valve replacement effectively improved the heart function of patients, reduced administration of vasoactive drugs, shortened length of ICU stay, reduced incidence of postoperative adverse events, and promoted recovery of patients after surgery.
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Sheng et al. (2021) conducted an RCT in Valvular heart disease (n=185). Levosimendan vs. Placebo (5% glucose solution) was evaluated on Left ventricular ejection fraction (LVEF) at 7 days after surgery (p=<0.001). Levosimendan administration immediately after heart valve replacement improved left ventricular ejection fraction at 7 days and reduced ICU length of stay compared to placebo.
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