Hemodynamic effects of a continuous infusion of levosimendan in critically ill patients with cardiogenic shock requiring catecholamines.

摘要: Background:  Levosimendan, a novel inodilator, has been shown to improve hemodynamic function in patients with decompensated heart failure preserved arterial blood pressure. Data on its use cardiogenic shock are rare. The present series describes the 24-h effects of levosimendan as add-on therapy desperately ill requiring catecholamines. Methods:  Ten received continuous infusion 0.1 µg kg−1 min−1 for 24 h. were otherwise unselected. Hemodynamic measurements routinely performed at baseline (time 0) and 1, 8, 16 24 h after start (LS) using Swan-Ganz thermodilution catheter. Results:  During there was significant increase cardiac index from 1.8 ± 0.4 2.4 ± 0.6 L*min−1*m−2 (P = 0.023) decrease systemic vascular resistance 1559 ± 430 1109 ± 202 dyn*s*cm−5 (P = 0.001), respectively. Changes catecholamine dose, systolic diastolic pressure not significant. Given individual response LS, 8/10 showed an left ventricular stroke work under reduced or roughly unchanged preload conditions 8 h. Conclusion:  This shows that LS is feasible able hemodynamics severely compromized, critically therapy. Its potential advantages when compared other inotropes unclear. To clarify role this clinical setting randomized controlled trials mortality endpoints needed.