Key result
Levosimendan significantly improved cardiac index and systemic vascular resistance index after OPCAB compared to placebo, but increased the need for norepinephrine infusion (60% vs 6.7%, P<0.05).
Why the study?
Does levosimendan improve perioperative hemodynamics and cardiac function in patients with good left ventricular function undergoing off-pump coronary artery bypass grafting?
RCT (n=30)
Double-blind
randomized
Does levosimendan improve perioperative hemodynamics and cardiac function in patients with good left ventricular function undergoing off-pump coronary artery bypass grafting?
Answers are grounded in this paper and cite their sources.
In patients with good left ventricular function undergoing OPCAB, prophylactic levosimendan improves hemodynamic parameters but increases the need for vasopressors without improving clinical outcomes.
AIMS AND OBJECTIVE: We tested the hypothesis that use of levosimendan would be associated with better perioperative hemodynamics and cardiac function during off-pump coronary artery bypass grafting (OPCAB) in patients with good left ventricular function. MATERIALS AND METHODS: Thirty patients scheduled for OPCAB were randomized in a double-blind manner to receive either levosimendan 0.1 μg/kg/min or placebo after induction of general anesthesia. The hemodynamic variables were measured after induction of anesthesia, at 6 minute after application of tissue stabilizer for the anastomoses of left anterior descending artery, diagonal artery, left circumflex artery, and right coronary artery and at 6, 12, 18, and 24 hours after completion of surgery. RESULTS: Compared with placebo group, cardiac index (CI) was significantly higher and systemic vascular resistance index (SVRI) was significantly lower at 6, 12, 18, and 24 hour after surgery in levosimendan group. Norepinephrine was infused in 60% of the patients in the levosimendan group compared to 6.7% in the control group ( P < 0.05). Lactate and mixed venous oxygen saturation were not significantly different between groups. CONCLUSIONS: Levosimendan significantly increased CI and decreased SVRI after OPCAB but it did not show any outcome benefit in terms of duration of ventilation and intensive care unit stay.
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Karthekeyan et al. (2013) conducted an RCT in Off-pump coronary artery bypass grafting (OPCAB) (n=30). Levosimendan vs. Placebo was evaluated on Perioperative hemodynamics and cardiac function (cardiac index and systemic vascular resistance index). Levosimendan significantly improved cardiac index and systemic vascular resistance index after OPCAB compared to placebo, but increased the need for norepinephrine infusion (60% vs 6.7%, P<0.05).
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