Effects of levosimendan on right ventricular afterload in patients with acute respiratory distress syndrome: a pilot study.

摘要: OBJECTIVE: Acute respiratory distress syndrome (ARDS) is frequently associated with increased pulmonary vascular resistance and thus systolic load of the right ventricle. We hypothesized that levosimendan, a new calcium sensitizer potential vasodilator properties, improves hemodynamics by unloading ventricle in patients ARDS. DESIGN: Prospective, randomized, placebo-controlled, pilot study. SETTING: Twenty-two-bed multidisciplinary intensive care unit university hospital. PATIENTS: Thirty-five ARDS association septic shock. INTERVENTIONS: Patients were randomly allocated to receive 24-hr infusion either levosimendan 0.2 microg/kg/min (n = 18) or placebo 17). Data from heart catheterization, cardiac magnetic resonance, arterial mixed venous oxygen tensions saturations, carbon dioxide obtained before 24 hrs after drug infusion. MEASUREMENTS AND MAIN RESULTS: At mean pressure between 70 80 mm Hg (sustained norepinephrine infusion), index (from 3.8 +/- 1.1 4.2 1.0 L/min/m) decreased artery 29 3 25 Hg) 290 77 213 50 dynes/s/cm(5)/m(2); each p < .05). Levosimendan also ventricular end-systolic volume ejection fraction (p In addition, saturation 63 8 8%; .01). CONCLUSIONS: This study provides evidence performance through effects A large multiple-center trial needed investigate whether able improve overall prognosis sepsis (Less)