Levosimendan does not provide mortality benefit over dobutamine in adult patients with septic shock: A meta-analysis of randomized controlled trials

Journal of Clinical Anesthesia
Sulagna BhattacharjeeDalim K Baidya

Abstract

Despite of advancement in intensive care medicine, sepsis and septic shock carry a high mortality. Levosimendan, an inodilator, may be promising for septic shock patients with myocardial dysfunction; however, firm evidence is lacking. In this meta- analysis of randomized controlled trials, levosimendan has been compared with dobutamine in adult patients with sepsis and septic shock. Meta-analysis of randomized controlled trial. Intensive-care unit. Adult septic shock patients. Adult septic shock patients received dobutamine or levosimendan. Mortality at longest follow-up, blood lactate level, cardiac index and noradrenaline requirement. Data from 7 randomized trials have been included in this meta-analysis. Levosimendan has no benefit in terms of mortality at longest follow up in comparison to dobutamine (Odds ratio 0.77, 95% CI 0.45, 132; p=0.34) and length of ICU stay (MD -4.7days, 95% CI -10.3, 0.9days, p=0.10). Patients received levosimendan had less blood lactate level (standardized mean difference -0.95; 95% CI -1.64, -0.27; p=0.006) and higher cardiac index (mean difference 0.44; 95% CI 0.17, 0.71; p=0.001). Noradrenaline requirements are similar in both the groups. There is no evidence that levosimendan is superior to d...Continue Reading

Citations

May 31, 2018·Current Opinion in Critical Care·Keith R Walley
Oct 24, 2019·BioMed Research International·Jian PanYuan-Qiang Lu
Jan 30, 2021·Annals of Intensive Care·Thomas W L ScheerenJean-Louis Teboul
Oct 3, 2020·Bioorganic & Medicinal Chemistry·Pulla Reddy BogguSang-Hun Jung
Jun 6, 2021·Journal of Critical Care·Sharon EinavAndrea Cortegiani
Dec 16, 2021·Intensive Care Medicine·Jan BakkerGlenn Hernandez

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