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Preoperative and perioperative use of levosimendan in cardiac surgery: European expert opinion
W. Toller, M. Heringlake, F. Guarracino, L. Algotsson, J. Alvarez, H. Argyriadou, T. Ben-Gal, V. Černý, B. Cholley, A. Eremenko, JL. Guerrero-Orriach, K. Järvelä, N. Karanovic, M. Kivikko, P. Lahtinen, V. Lomivorotov, RH. Mehta, Š. Mušič, P....
Jazyk angličtina Země Nizozemsko
Typ dokumentu časopisecké články, přehledy
- MeSH
- hydrazony terapeutické užití MeSH
- kardiochirurgické výkony škodlivé účinky metody MeSH
- kardiotonika terapeutické užití MeSH
- kardiovaskulární nemoci farmakoterapie epidemiologie chirurgie MeSH
- klinické zkoušky jako téma metody MeSH
- lidé MeSH
- perioperační péče metody MeSH
- předoperační péče metody MeSH
- pyridaziny terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Evropa MeSH
In cardiac surgery, postoperative low cardiac output has been shown to correlate with increased rates of organ failure and mortality. Catecholamines have been the standard therapy for many years, although they carry substantial risk for adverse cardiac and systemic effects, and have been reported to be associated with increased mortality. On the other hand, the calcium sensitiser and potassium channel opener levosimendan has been shown to improve cardiac function with no imbalance in oxygen consumption, and to have protective effects in other organs. Numerous clinical trials have indicated favourable cardiac and non-cardiac effects of preoperative and perioperative administration of levosimendan. A panel of 27 experts from 18 countries has now reviewed the literature on the use of levosimendan in on-pump and off-pump coronary artery bypass grafting and in heart valve surgery. This panel discussed the published evidence in these various settings, and agreed to vote on a set of questions related to the cardioprotective effects of levosimendan when administered preoperatively, with the purpose of reaching a consensus on which patients could benefit from the preoperative use of levosimendan and in which kind of procedures, and at which doses and timing should levosimendan be administered. Here, we present a systematic review of the literature to report on the completed and ongoing studies on levosimendan, including the newly commenced LEVO-CTS phase III study (NCT02025621), and on the consensus reached on the recommendations proposed for the use of preoperative levosimendan.
B 5 Petrovsky Russian National Centre of Surgery Moscow Russia
Department of Anaesthesiology and Intensive Care Kuopio University Hospital Kuopio Finland
Department of Anaesthesiology and Intensive Care Medicine University Hospital of Graz Graz Austria
Department of Anaesthesiology and Intensive Care University Hospital Split Split Croatia
Department of Anaesthesiology University of Lübeck Lübeck Germany
Department of Anaesthesiology UZ Leuven Campus Gasthuisberg Leuven Belgium
Department of Cardio Anaesthesiology University Clinical Centre Ljubljana Ljubljana Slovenia
Department of Cardiothoracic Surgery Karolinska University Hospital Solna Stockholm Sweden
Department of Cardiothoracic Surgery Skånes University Hospital Lund Lund Sweden
Department of Critical Care St Thomas' Hospital London UK
E N Meshalkin State Novosibirsk Research Institute of Circulation Pathology Novosibirsk Russia
Heart Centre and Intensive Care Unit Tampere University Hospital Tampere Finland
Heart Failure Unit Rabin Medical Centre Petach Tikva Israel
Institute of Anaesthesiology University Hospital of Zürich Zürich Switzerland
Citace poskytuje Crossref.org
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- $a Toller, W $u Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Graz, Graz, Austria. Electronic address: wolfgang.toller@medunigraz.at.
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- $a In cardiac surgery, postoperative low cardiac output has been shown to correlate with increased rates of organ failure and mortality. Catecholamines have been the standard therapy for many years, although they carry substantial risk for adverse cardiac and systemic effects, and have been reported to be associated with increased mortality. On the other hand, the calcium sensitiser and potassium channel opener levosimendan has been shown to improve cardiac function with no imbalance in oxygen consumption, and to have protective effects in other organs. Numerous clinical trials have indicated favourable cardiac and non-cardiac effects of preoperative and perioperative administration of levosimendan. A panel of 27 experts from 18 countries has now reviewed the literature on the use of levosimendan in on-pump and off-pump coronary artery bypass grafting and in heart valve surgery. This panel discussed the published evidence in these various settings, and agreed to vote on a set of questions related to the cardioprotective effects of levosimendan when administered preoperatively, with the purpose of reaching a consensus on which patients could benefit from the preoperative use of levosimendan and in which kind of procedures, and at which doses and timing should levosimendan be administered. Here, we present a systematic review of the literature to report on the completed and ongoing studies on levosimendan, including the newly commenced LEVO-CTS phase III study (NCT02025621), and on the consensus reached on the recommendations proposed for the use of preoperative levosimendan.
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