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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| مؤلفون آخرون: | , , , , , |
| التنسيق: | article |
| منشور في: |
2025
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| 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 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| 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 |