Key result
Levosimendan showed no significant difference in all-cause mortality compared to intra-aortic balloon pump, but significantly reduced the length of ICU stay and duration of mechanical ventilation in patients undergoing coronary artery bypass graft surgery.
Why the study?
The study was conducted to compare postoperative outcomes between intra-aortic balloon pump and levosimendan in patients undergoing CABG surgery.
Does levosimendan improve postoperative outcomes compared to an intra-aortic balloon pump in adult patients undergoing coronary artery bypass graft surgery?
Meta-Analysis (n=641)
Does levosimendan improve postoperative outcomes compared to an intra-aortic balloon pump in adult patients undergoing coronary artery bypass graft surgery?
Relative Risk: 1.07 (95% CI 0.62–1.85)
p-value: p=0.80
Levosimendan may serve as a viable, less invasive alternative to IABP in high-risk patients undergoing CABG, as it significantly reduces ICU stay and mechanical ventilation duration without increasing mortality or arrhythmias.
Levosimendan may shorten ICU stay and ventilation versus IABP after CABG; extends meta-analytic support for its use as alternative in high-risk patients.
This study was conducted to compare the postoperative outcomes between intra-aortic balloon pump (IABP) and levosimendan in patients undergoing coronary artery bypass graft (CABG) surgery. This meta-analysis was conducted following the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). For this meta-analysis, a literature search was performed on PubMed, Cochrane Central Register of Controlled Trials, and EMBASE from inception to July 15, 2023. Keywords used to search for relevant articles included "intra-aortic balloon," "levosimendan," and "cardiac surgery" along with their key terms and Medical Subject Headings (MeSH) terms. Outcomes assessed in this study included postoperative outcomes like all-cause mortality, postoperative arrhythmias, need for inotropic support, length of intensive care unit stay (ICU) in days, and duration of mechanical ventilation in hours. Other outcomes included two-hour, six-hour, and 24-hour postoperative central venous pressure (CVP), mean atrial pressure (MAP), and heart rate (HR). A total of eight studies were included in the pooled analysis. The pooled results found that the length of ICU stay and the duration of mechanical ventilation were significantly higher in patients receiving IABP. Additionally, the findings of this meta-analysis showed a higher need for inotropic support in patients receiving IABP compared to patients receiving levosimendan but the difference was statistically insignificant. However, no significant differences were found between the two groups in terms of mortality and arrhythmias. In conclusion, patients treated with levosimendan exhibited significant advantages, as they experienced shorter ICU stays and reduced duration of mechanical ventilation compared to the IABP group and less requirement for inotropic support.
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Al-Tekreeti et al. (2023) conducted a meta-analysis in Coronary artery bypass graft (CABG) (n=641). Levosimendan vs. Intra-aortic balloon pump (IABP) was evaluated on All-cause mortality (RR 1.07, 95% CI 0.62 to 1.85, p=0.80). Levosimendan showed no significant difference in all-cause mortality compared to intra-aortic balloon pump, but significantly reduced the length of ICU stay and duration of mechanical ventilation in patients undergoing coronary artery bypass graft surgery.
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