The Role of Levosimendan in Extracorporeal Membrane Oxygenation for Refractory Cardiac Arrest

ObjectivesTo examine whether levosimendan could improve survival in patients with cardiac arrest supported by extracorporeal cardiopulmonary resuscitation (ECPR). DesignA retrospective cohort study. SettingSingle tertiary academic center. ParticipantsPatients with refractory cardiac arrest. Interven...

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محفوظ في:
التفاصيل البيبلوغرافية
المؤلف الرئيسي: Rasha, Kaddoura (author)
مؤلفون آخرون: Orabi, Bassant (author), Omar, Amr S. (author), Ibrahim, Mohamed Izham Mohamed (author), Alyafei, Sumaya Alsaadi (author), Alkhulaifi, Abdulaziz (author), Shehatta, Ahmed Labib (author)
التنسيق: article
منشور في: 2025
الموضوعات:
الوصول للمادة أونلاين:http://dx.doi.org/10.1053/j.jvca.2025.01.004
https://www.sciencedirect.com/science/article/pii/S1053077025000308
http://hdl.handle.net/10576/64181
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_version_ 1857415085795835904
author Rasha, Kaddoura
author2 Orabi, Bassant
Omar, Amr S.
Ibrahim, Mohamed Izham Mohamed
Alyafei, Sumaya Alsaadi
Alkhulaifi, Abdulaziz
Shehatta, Ahmed Labib
author2_role author
author
author
author
author
author
author_facet Rasha, Kaddoura
Orabi, Bassant
Omar, Amr S.
Ibrahim, Mohamed Izham Mohamed
Alyafei, Sumaya Alsaadi
Alkhulaifi, Abdulaziz
Shehatta, Ahmed Labib
author_role author
dc.creator.none.fl_str_mv Rasha, Kaddoura
Orabi, Bassant
Omar, Amr S.
Ibrahim, Mohamed Izham Mohamed
Alyafei, Sumaya Alsaadi
Alkhulaifi, Abdulaziz
Shehatta, Ahmed Labib
dc.date.none.fl_str_mv 2025-04-13T11:40:16Z
2025-04
dc.format.none.fl_str_mv application/pdf
dc.identifier.none.fl_str_mv http://dx.doi.org/10.1053/j.jvca.2025.01.004
Kaddoura, R., Orabi, B., Omar, A. S., Ibrahim, M. I. M., Alyafei, S. A., Alkhulaifi, A., & Shehatta, A. L. (2025). The Role of Levosimendan in Extracorporeal Membrane Oxygenation for Refractory Cardiac Arrest. Journal of Cardiothoracic and Vascular Anesthesia.
1053-0770
https://www.sciencedirect.com/science/article/pii/S1053077025000308
http://hdl.handle.net/10576/64181
4
39
1532-8422
dc.language.none.fl_str_mv en
dc.publisher.none.fl_str_mv Elsevier
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv 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 Article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/article
description ObjectivesTo examine whether levosimendan could improve survival in patients with cardiac arrest supported by extracorporeal cardiopulmonary resuscitation (ECPR). DesignA retrospective cohort study. SettingSingle tertiary academic center. ParticipantsPatients with refractory cardiac arrest. InterventionsPatients who were exposed to levosimendan and those who were not. Measurement and Main ResultsThere were 87 patients with a mean age of 45.4 ± 11.9 years, 86.2% of them were males with a mean body mass index of 26.8 ± 5.0 kg/m2, and a mean Charlson Comorbidity 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 out of hospital cardiac arrest. Median cardiopulmonary resuscitation duration before extracorporeal membrane oxygenation 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 intensive care unit stay (19.1 vs 18.2 days), length of hospital stay (51.1 days vs 53.4 days), or complications rates (eg, infection, bleeding, and arrhythmias). ConclusionsLevosimendan 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.
eu_rights_str_mv openAccess
format article
id qu_16bd339f25eab4b99bb5f9ce62ac8a74
identifier_str_mv Kaddoura, R., Orabi, B., Omar, A. S., Ibrahim, M. I. M., Alyafei, S. A., Alkhulaifi, A., & Shehatta, A. L. (2025). The Role of Levosimendan in Extracorporeal Membrane Oxygenation for Refractory Cardiac Arrest. Journal of Cardiothoracic and Vascular Anesthesia.
1053-0770
4
39
1532-8422
language_invalid_str_mv en
network_acronym_str qu
network_name_str Qatar University repository
oai_identifier_str oai:qspace.qu.edu.qa:10576/64181
publishDate 2025
publisher.none.fl_str_mv Elsevier
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repository.name.fl_str_mv
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rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
spelling The Role of Levosimendan in Extracorporeal Membrane Oxygenation for Refractory Cardiac ArrestRasha, KaddouraOrabi, BassantOmar, Amr S.Ibrahim, Mohamed Izham MohamedAlyafei, Sumaya AlsaadiAlkhulaifi, AbdulazizShehatta, Ahmed Labibcardiac arrestcardiopulmonary resuscitationcerebral performance categoryECPRECMOELSOinotropesneurological outcomeObjectivesTo examine whether levosimendan could improve survival in patients with cardiac arrest supported by extracorporeal cardiopulmonary resuscitation (ECPR). DesignA retrospective cohort study. SettingSingle tertiary academic center. ParticipantsPatients with refractory cardiac arrest. InterventionsPatients who were exposed to levosimendan and those who were not. Measurement and Main ResultsThere were 87 patients with a mean age of 45.4 ± 11.9 years, 86.2% of them were males with a mean body mass index of 26.8 ± 5.0 kg/m2, and a mean Charlson Comorbidity 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 out of hospital cardiac arrest. Median cardiopulmonary resuscitation duration before extracorporeal membrane oxygenation 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 intensive care unit stay (19.1 vs 18.2 days), length of hospital stay (51.1 days vs 53.4 days), or complications rates (eg, infection, bleeding, and arrhythmias). ConclusionsLevosimendan 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.Open access publication fee funding was provided by Qatar National Library.Elsevier2025-04-13T11:40:16Z2025-04Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://dx.doi.org/10.1053/j.jvca.2025.01.004Kaddoura, R., Orabi, B., Omar, A. S., Ibrahim, M. I. M., Alyafei, S. A., Alkhulaifi, A., & Shehatta, A. L. (2025). The Role of Levosimendan in Extracorporeal Membrane Oxygenation for Refractory Cardiac Arrest. Journal of Cardiothoracic and Vascular Anesthesia.1053-0770https://www.sciencedirect.com/science/article/pii/S1053077025000308http://hdl.handle.net/10576/641814391532-8422enhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:qspace.qu.edu.qa:10576/641812025-04-13T19:06:47Z
spellingShingle The Role of Levosimendan in Extracorporeal Membrane Oxygenation for Refractory Cardiac Arrest
Rasha, Kaddoura
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 cardiac arrest
cardiopulmonary resuscitation
cerebral performance category
ECPR
ECMO
ELSO
inotropes
neurological outcome
url http://dx.doi.org/10.1053/j.jvca.2025.01.004
https://www.sciencedirect.com/science/article/pii/S1053077025000308
http://hdl.handle.net/10576/64181