Poster Sessions: Haemostasis/Cardiac Anaesthesia
Evidence for preconditioning by levosimendan in coronary artery bypass grafting
Introduction: The calcium sensitizer levosimendan has been shown to protect against myocardial ischaemia and reperfusion injury in animal models. The present study investigated whether these effects were clinically relevant and would protect the myocardium during coronary artery bypass grafting (CABG).
Method: Twenty-four patients with stable angina scheduled for elective CABG surgery were equally randomized into control and levosimendan (Levo) groups. In the Levo group, 24 μg/kg levosimendan was infused intravenously over a 10 minute period just prior to placing the patient on cardiopulmonary bypass. A time-matched placebo infusion was given to control patients. Perioperative haemodynamic variables, concentrations of cardiac troponin I over the 48h post-operative period, and clinical outcomes were assessed.
Results: There were no adverse effects related to levosimendan. Postoperative troponin I concentrations in the Levo group were significantly lower than control (P < 0.05). Levo-treated patients had significantly higher cardiac indices (CI) (P < 0.05), spent less time receiving mechanical ventilation (9.8 ± 2.6 vs. 11.2 ± 2.5h) and had shorter intensive care and postoperative hospital length of stays (27.3 ± 7.5 vs. 33.6 ± 10 h, and 11.5 ± 2 vs. 13 ± 2 days, respectively).
Conclusion: Patients receiving levosimendan during cardiopulmonary bypass surgery showed improved outcomes and evidence of less myocardial damage.© 2006 European Society of Anaesthesiology