Abstract
Objective: Catecholaminergic inotropes have a place in the management of low output syndrome and decompensated heart failure but their effect on mortality is debated. Levosimendan is a calcium sensitizer that enhances myocardial contractility without increasing myocardial oxygen use. A meta-analysis was conducted to determine the impact of levosimendan on mortality and hospital stay. Data Sources: BioMedCentral, PubMed, Embase, and the Cochrane Central Register of clinical trials were searched for pertinent studies. International experts and the manufacturer were contacted. Study Selection: Articles were assessed by four trained investigators, with divergences resolved by consensus. Inclusion criteria were random allocation to treatment and comparison of levosimendan vs. control. There were no restrictions on dose or time of levosimendan administration or on language. Exclusion criteria were: duplicate publications, nonadult studies, oral administration of levosimendan, and no data on main outcomes. Data Extraction: Study end points, main outcomes, study design, population, clinical setting, levosimendan dosage, and treatment duration were extracted. Data Synthesis: Data from 5,480 patients in 45 randomized clinical trials were analyzed. The overall mortality rate was 17.4% (507 of 2,915) among levosimendan-treated patients and 23.3% (598 of 2,565) in the control group (risk ratio 0.80 [0.72; 0.89], p for effect
| Original language | English |
|---|---|
| Pages (from-to) | 634-646 |
| Number of pages | 13 |
| Journal | Critical Care Medicine |
| Volume | 40 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Feb 2012 |
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Keywords
- anesthesia
- cardiac surgery
- heart failure
- inotropic support
- intensive care
- levosimendan
- mortality
- survival
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
Cite this
Effects of levosimendan on mortality and hospitalization. A meta-analysis of randomized controlled studies. / Landoni, Giovanni; Biondi-Zoccai, Giuseppe; Greco, Massimiliano; Greco, Teresa; Bignami, Elena; Morelli, Andrea; Guarracino, Fabio; Zangrillo, Alberto.
In: Critical Care Medicine, Vol. 40, No. 2, 02.2012, p. 634-646.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effects of levosimendan on mortality and hospitalization. A meta-analysis of randomized controlled studies
AU - Landoni, Giovanni
AU - Biondi-Zoccai, Giuseppe
AU - Greco, Massimiliano
AU - Greco, Teresa
AU - Bignami, Elena
AU - Morelli, Andrea
AU - Guarracino, Fabio
AU - Zangrillo, Alberto
PY - 2012/2
Y1 - 2012/2
N2 - Objective: Catecholaminergic inotropes have a place in the management of low output syndrome and decompensated heart failure but their effect on mortality is debated. Levosimendan is a calcium sensitizer that enhances myocardial contractility without increasing myocardial oxygen use. A meta-analysis was conducted to determine the impact of levosimendan on mortality and hospital stay. Data Sources: BioMedCentral, PubMed, Embase, and the Cochrane Central Register of clinical trials were searched for pertinent studies. International experts and the manufacturer were contacted. Study Selection: Articles were assessed by four trained investigators, with divergences resolved by consensus. Inclusion criteria were random allocation to treatment and comparison of levosimendan vs. control. There were no restrictions on dose or time of levosimendan administration or on language. Exclusion criteria were: duplicate publications, nonadult studies, oral administration of levosimendan, and no data on main outcomes. Data Extraction: Study end points, main outcomes, study design, population, clinical setting, levosimendan dosage, and treatment duration were extracted. Data Synthesis: Data from 5,480 patients in 45 randomized clinical trials were analyzed. The overall mortality rate was 17.4% (507 of 2,915) among levosimendan-treated patients and 23.3% (598 of 2,565) in the control group (risk ratio 0.80 [0.72; 0.89], p for effect
AB - Objective: Catecholaminergic inotropes have a place in the management of low output syndrome and decompensated heart failure but their effect on mortality is debated. Levosimendan is a calcium sensitizer that enhances myocardial contractility without increasing myocardial oxygen use. A meta-analysis was conducted to determine the impact of levosimendan on mortality and hospital stay. Data Sources: BioMedCentral, PubMed, Embase, and the Cochrane Central Register of clinical trials were searched for pertinent studies. International experts and the manufacturer were contacted. Study Selection: Articles were assessed by four trained investigators, with divergences resolved by consensus. Inclusion criteria were random allocation to treatment and comparison of levosimendan vs. control. There were no restrictions on dose or time of levosimendan administration or on language. Exclusion criteria were: duplicate publications, nonadult studies, oral administration of levosimendan, and no data on main outcomes. Data Extraction: Study end points, main outcomes, study design, population, clinical setting, levosimendan dosage, and treatment duration were extracted. Data Synthesis: Data from 5,480 patients in 45 randomized clinical trials were analyzed. The overall mortality rate was 17.4% (507 of 2,915) among levosimendan-treated patients and 23.3% (598 of 2,565) in the control group (risk ratio 0.80 [0.72; 0.89], p for effect
KW - anesthesia
KW - cardiac surgery
KW - heart failure
KW - inotropic support
KW - intensive care
KW - levosimendan
KW - mortality
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=84856185198&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84856185198&partnerID=8YFLogxK
U2 - 10.1097/CCM.0b013e318232962a
DO - 10.1097/CCM.0b013e318232962a
M3 - Article
C2 - 21963578
AN - SCOPUS:84856185198
VL - 40
SP - 634
EP - 646
JO - Critical Care Medicine
JF - Critical Care Medicine
SN - 0090-3493
IS - 2
ER -