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Preoperative and perioperative use of levosimendan in cardiac surgery: European expert opinion.
Journal article

Preoperative and perioperative use of levosimendan in cardiac surgery: European expert opinion.

  • Toller W Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Graz, Graz, Austria. Electronic address: wolfgang.toller@medunigraz.at.
  • Heringlake M Department of Anaesthesiology, University of Lübeck, Lübeck, Germany.
  • Guarracino F Department of Anaesthesia and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
  • Algotsson L Department of Cardiothoracic Surgery, Skånes University Hospital Lund, Lund, Sweden.
  • Alvarez J Department of Anaesthesiology and Intensive Care, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
  • Argyriadou H Department of Anaesthesiology and Intensive Care Unit, Aristotle University of Thessaloniki, AHEPA Teaching Hospital, Thessaloniki, Greece.
  • Ben-Gal T Heart Failure Unit, Rabin Medical Centre, Petach Tikva, Israel.
  • Černý V Department of Anaesthesiology and Intensive Care, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
  • Cholley B Department of Anaesthesiology and Intensive Care, Hôpital Européen Georges Pompidou, AP-HP, Paris, France; Université Paris Descartes, Paris, France.
  • Eremenko A "B. V. Petrovsky" Russian National Centre of Surgery, Moscow, Russia.
  • Guerrero-Orriach JL Department of Cardio-Anaesthesiology, University Hospital Virgen de la Victoria de Malaga, Malaga, Spain.
  • Järvelä K Heart Centre and Intensive Care Unit, Tampere University Hospital, Tampere, Finland.
  • Karanovic N Department of Anaesthesiology and Intensive Care, University Hospital Split, Split, Croatia.
  • Kivikko M Orion Pharma, Critical Care, Espoo, Finland.
  • Lahtinen P Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland.
  • Lomivorotov V "E. N. Meshalkin" State Novosibirsk Research Institute of Circulation Pathology, Novosibirsk, Russia.
  • Mehta RH Department of Internal Medicine and Cardiology, Duke University Medical Center and Duke Clinical Research Institute, Durham, NC, USA.
  • Mušič Š Department of Cardio-Anaesthesiology, University Clinical Centre Ljubljana, Ljubljana, Slovenia.
  • Pollesello P Orion Pharma, Critical Care, Espoo, Finland.
  • Rex S Department of Anaesthesiology, UZ Leuven, Campus Gasthuisberg, Leuven, Belgium.
  • Riha H Cardiothoracic Anaesthesiology and Intensive Care, Department of Anaesthesiology and Intensive Care Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
  • Rudiger A Institute of Anaesthesiology, University Hospital of Zürich, Zürich, Switzerland.
  • Salmenperä M Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Helsinki University Hospital, Helsinki, Finland.
  • Szudi L Department of Anaesthesiology and Intensive Care, Gottsegen György National Institute of Cardiology, Budapest, Hungary.
  • Tritapepe L Department of Anaesthesiology and Intensive Care, Policlinico "Umberto I", "La Sapienza" University of Rome, Rome, Italy.
  • Wyncoll D Department of Critical Care, St. Thomas' Hospital, London, UK.
  • Öwall A Department of Cardiothoracic Surgery, Karolinska University Hospital Solna, Stockholm, Sweden.
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  • 2015-03-04
Published in:
  • International journal of cardiology. - 2015
CABG
Cardiac surgery
Cardioprotective
Inodilator
Low cardiac output syndrome
Valve surgery
Cardiac Surgical Procedures
Cardiotonic Agents
Cardiovascular Diseases
Clinical Trials as Topic
Europe
Humans
Hydrazones
Perioperative Care
Preoperative Care
Pyridazines
Simendan
English 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.
Language
  • English
Open access status
hybrid
Identifiers
Persistent URL
https://sonar.ch/global/documents/166116
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