Can levosimendan reduce ECMO weaning failure in cardiogenic shock?: a cohort study with propensity score analysis.

Critical Care : the Official Journal of the Critical Care Forum
Enrique GuilhermeJean-Luc Fellahi

Abstract

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been increasingly used over the last decade in patients with refractory cardiogenic shock. ECMO weaning can, however, be challenging and lead to circulatory failure and death. Recent data suggest a potential benefit of levosimendan for ECMO weaning. We sought to further investigate whether the use of levosimendan could decrease the rate of ECMO weaning failure in adult patients with refractory cardiogenic shock. We performed an observational single-center cohort study. All patients undergoing VA-ECMO from January 2012 to December 2018 were eligible and divided into two groups: group levosimendan and group control (without levosimendan). The primary endpoint was VA-ECMO weaning failure defined as death during VA-ECMO treatment or within 24 h after VA-ECMO removal. Secondary outcomes were mortality at day 28 and at 6 months. The two groups were compared after propensity score matching. P < 0.05 was considered statistically significant. Two hundred patients were analyzed (levosimendan group: n = 53 and control group: n = 147). No significant difference was found between groups on baseline characteristics except for ECMO duration, which was longer in the levosimendan g...Continue Reading

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Citations

Aug 8, 2020·Critical Care : the Official Journal of the Critical Care Forum·Enrique GuilhermeJean-Luc Fellahi
Feb 5, 2021·Expert Review of Medical Devices·Christopher GaisendreesThorsten Wahlers
May 20, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Saumil J Patel, John G Augoustides
Apr 3, 2021·Current Opinion in Critical Care·Daniel De BackerBruno Levy
Aug 12, 2021·Drug Design, Development and Therapy·Nicolina ContiLuciano Potena

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Clinical Trials Mentioned

NCT04323709

Software Mentioned

STATA

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