The Role of Levosimendan in Extracorporeal Membrane Oxygenation for Refractory Cardiac Arrest
<h3>Objectives</h3><p dir="ltr">To examine whether levosimendan could improve survival in patients with cardiac arrest supported by extracorporeal cardiopulmonary resuscitation (ECPR). </p><h3>Design </h3><p dir="ltr"><u>Retrospecti...
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | , , , , , |
| Published: |
2025
|
| Subjects: | |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1864513538603614208 |
|---|---|
| author | Rasha Kaddoura (12506936) |
| author2 | Bassant Orabi (17269123) Amr S. Omar (16932537) Mohamed Izham Mohamed Ibrahim (10221287) Sumaya Alsaadi Alyafei (17380426) Abdulaziz Alkhulaifi (16932540) Ahmed Labib Shehatta (17347069) |
| author2_role | author author author author author author |
| author_facet | Rasha Kaddoura (12506936) Bassant Orabi (17269123) Amr S. Omar (16932537) Mohamed Izham Mohamed Ibrahim (10221287) Sumaya Alsaadi Alyafei (17380426) Abdulaziz Alkhulaifi (16932540) Ahmed Labib Shehatta (17347069) |
| author_role | author |
| dc.creator.none.fl_str_mv | Rasha Kaddoura (12506936) Bassant Orabi (17269123) Amr S. Omar (16932537) Mohamed Izham Mohamed Ibrahim (10221287) Sumaya Alsaadi Alyafei (17380426) Abdulaziz Alkhulaifi (16932540) Ahmed Labib Shehatta (17347069) |
| dc.date.none.fl_str_mv | 2025-04-01T00:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1053/j.jvca.2025.01.004 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/The_Role_of_Levosimendan_in_Extracorporeal_Membrane_Oxygenation_for_Refractory_Cardiac_Arrest/30197965 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Cardiovascular medicine and haematology Clinical sciences Pharmacology and pharmaceutical sciences cardiac arrest cardiopulmonary resuscitation cerebral performance category ECPR ECMO ELSO inotropes neurological outcome |
| dc.title.none.fl_str_mv | The Role of Levosimendan in Extracorporeal Membrane Oxygenation for Refractory Cardiac Arrest |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Objectives</h3><p dir="ltr">To examine whether levosimendan could improve survival in patients with cardiac arrest supported by extracorporeal cardiopulmonary resuscitation (ECPR). </p><h3>Design </h3><p dir="ltr"><u>Retrospective cohort study</u>. </p><h3>Setting</h3><p dir="ltr">Single tertiary academic center. </p><h3>Participants </h3><p dir="ltr">Patients with refractory cardiac arrest. </p><h3>Interventions </h3><p dir="ltr">Patients who were exposed to<u> levosimendan </u>and those who were not. </p><h3>Measurement and Main Results</h3><p dir="ltr">There were 87 patients with a mean age of 45.4 ± 11.9 years, 86.2% of them were males with a mean <u>body mass index</u> of 26.8 ± 5.0 kg/m<sup>2</sup>, and a mean <u>Charlson Comorbidity</u> Index score of 0.7 ± 1.3. Of the 87 patients, 18 (20.7%) were administered levosimendan. The 2 groups were similar in terms of baseline characteristics. Overall, 70% of patients in both groups suffered in-hospital cardiac arrest and the remaining suffered <u>out of hospital cardiac arrest</u>. Median cardiopulmonary resuscitation duration before <u>extracorporeal membrane oxygenation</u> initiation was 54.0 minutes (interquartile range, 35.0–84.0 minutes). The highest lactate levels after between the second and the fourth days after ECPR were significantly higher (8.1 mmol/L vs 3.4 mmol/L; p = 0.046) and the duration of extracorporeal membrane oxygenation support was significantly longer (4.2 days vs 1.9 days; p = 0.0019) with levosimendan. There was no difference between the groups in terms of survival to decannulation (27.8% vs 26.1%), survival to hospital discharge (27.8% vs 24.6%), length of <u>intensive care unit</u> stay (19.1 vs 18.2 days), length of hospital stay (51.1 days vs 53.4 days), or complications rates (eg, infection, <u>bleeding</u>, and arrhythmias). </p><h3>Conclusions</h3><p dir="ltr">Levosimendan use in ECPR did not improve survival. Future well-designed randomized trials are warranted to investigate the potential benefit of levosimendan in the ECPR setting.</p><h2>Other Information</h2><p dir="ltr">Published in: Journal of Cardiothoracic and Vascular Anesthesia<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1053/j.jvca.2025.01.004" target="_blank">https://dx.doi.org/10.1053/j.jvca.2025.01.004</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_aea84f1553ec9babe90d5f907aa08a4e |
| identifier_str_mv | 10.1053/j.jvca.2025.01.004 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/30197965 |
| publishDate | 2025 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | The Role of Levosimendan in Extracorporeal Membrane Oxygenation for Refractory Cardiac ArrestRasha Kaddoura (12506936)Bassant Orabi (17269123)Amr S. Omar (16932537)Mohamed Izham Mohamed Ibrahim (10221287)Sumaya Alsaadi Alyafei (17380426)Abdulaziz Alkhulaifi (16932540)Ahmed Labib Shehatta (17347069)Biomedical and clinical sciencesCardiovascular medicine and haematologyClinical sciencesPharmacology and pharmaceutical sciencescardiac arrestcardiopulmonary resuscitationcerebral performance categoryECPRECMOELSOinotropesneurological outcome<h3>Objectives</h3><p dir="ltr">To examine whether levosimendan could improve survival in patients with cardiac arrest supported by extracorporeal cardiopulmonary resuscitation (ECPR). </p><h3>Design </h3><p dir="ltr"><u>Retrospective cohort study</u>. </p><h3>Setting</h3><p dir="ltr">Single tertiary academic center. </p><h3>Participants </h3><p dir="ltr">Patients with refractory cardiac arrest. </p><h3>Interventions </h3><p dir="ltr">Patients who were exposed to<u> levosimendan </u>and those who were not. </p><h3>Measurement and Main Results</h3><p dir="ltr">There were 87 patients with a mean age of 45.4 ± 11.9 years, 86.2% of them were males with a mean <u>body mass index</u> of 26.8 ± 5.0 kg/m<sup>2</sup>, and a mean <u>Charlson Comorbidity</u> Index score of 0.7 ± 1.3. Of the 87 patients, 18 (20.7%) were administered levosimendan. The 2 groups were similar in terms of baseline characteristics. Overall, 70% of patients in both groups suffered in-hospital cardiac arrest and the remaining suffered <u>out of hospital cardiac arrest</u>. Median cardiopulmonary resuscitation duration before <u>extracorporeal membrane oxygenation</u> initiation was 54.0 minutes (interquartile range, 35.0–84.0 minutes). The highest lactate levels after between the second and the fourth days after ECPR were significantly higher (8.1 mmol/L vs 3.4 mmol/L; p = 0.046) and the duration of extracorporeal membrane oxygenation support was significantly longer (4.2 days vs 1.9 days; p = 0.0019) with levosimendan. There was no difference between the groups in terms of survival to decannulation (27.8% vs 26.1%), survival to hospital discharge (27.8% vs 24.6%), length of <u>intensive care unit</u> stay (19.1 vs 18.2 days), length of hospital stay (51.1 days vs 53.4 days), or complications rates (eg, infection, <u>bleeding</u>, and arrhythmias). </p><h3>Conclusions</h3><p dir="ltr">Levosimendan use in ECPR did not improve survival. Future well-designed randomized trials are warranted to investigate the potential benefit of levosimendan in the ECPR setting.</p><h2>Other Information</h2><p dir="ltr">Published in: Journal of Cardiothoracic and Vascular Anesthesia<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1053/j.jvca.2025.01.004" target="_blank">https://dx.doi.org/10.1053/j.jvca.2025.01.004</a></p>2025-04-01T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1053/j.jvca.2025.01.004https://figshare.com/articles/journal_contribution/The_Role_of_Levosimendan_in_Extracorporeal_Membrane_Oxygenation_for_Refractory_Cardiac_Arrest/30197965CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/301979652025-04-01T00:00:00Z |
| spellingShingle | The Role of Levosimendan in Extracorporeal Membrane Oxygenation for Refractory Cardiac Arrest Rasha Kaddoura (12506936) Biomedical and clinical sciences Cardiovascular medicine and haematology Clinical sciences Pharmacology and pharmaceutical sciences cardiac arrest cardiopulmonary resuscitation cerebral performance category ECPR ECMO ELSO inotropes neurological outcome |
| status_str | publishedVersion |
| title | The Role of Levosimendan in Extracorporeal Membrane Oxygenation for Refractory Cardiac Arrest |
| title_full | The Role of Levosimendan in Extracorporeal Membrane Oxygenation for Refractory Cardiac Arrest |
| title_fullStr | The Role of Levosimendan in Extracorporeal Membrane Oxygenation for Refractory Cardiac Arrest |
| title_full_unstemmed | The Role of Levosimendan in Extracorporeal Membrane Oxygenation for Refractory Cardiac Arrest |
| title_short | The Role of Levosimendan in Extracorporeal Membrane Oxygenation for Refractory Cardiac Arrest |
| title_sort | The Role of Levosimendan in Extracorporeal Membrane Oxygenation for Refractory Cardiac Arrest |
| topic | Biomedical and clinical sciences Cardiovascular medicine and haematology Clinical sciences Pharmacology and pharmaceutical sciences cardiac arrest cardiopulmonary resuscitation cerebral performance category ECPR ECMO ELSO inotropes neurological outcome |