Introduction: The aim of the study was to evaluate the effects of levosimendan, a new calcium sensitizer, used during cardiac surgery to facilitate separation from cardiopulmonary bypass (CPB) .
Method: Twenty ASA II-III patients, undergoing elective CABG, received, after the aortic clamp release, the same loading dose of levosimendan of 24 μg kg−1 over 10 minutes, followed by a continuous infusion of 0.1 μg kg−1 min−1 (group I, n = 10) or 0.2 μg kg−1 min−1 (group II, n = 10). All patients had measured ejection fraction >25%, sinus rhythm, cardiac index (CI) >1.8L min−1 m−2, mean arterial pressure (MAP) >60mmHg and pulmonary capillary wedge pressure (PCWP) 8-20 mmHg. They all received the same anaesthetic scheme. Cardiac output (CO) was obtained by Swan-Ganz catheter and thermodilution (Baxter-Edwards Lab). Haemodynamic measurements: Heart Rate (HR), MAP, PCWP, CO, CI, stroke volume (SV), systemic vascular resistance (SVR) were performed at: T0: baseline, T1 at 15min after infusion, T2 at 60min, T3 after 12 h and T4 at 24 h after the end of infusion. Statistical analysis was performed by ANOVA for repeated measurements, P < 0.05 was considered significant.
Results: There were no significant differences in the demographic data. Haemodynamic results are shown in the table.
Conclusion: Both doses of levosimendan were effective, achieving a successful separation from CPB during the initial attempt. Levosimendan may offer an alternative inotropic therapy in patients following cardiac surgery. The effects of the drug were not abolished after terminating the infusion .
1 Follath F, Cleland JG, Just H, et al. Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low-output heart failure (the LIDO study): a randomised double-blind trial. Lancet
2 Lilleberg J, Nieminen MS, Akkila J, et al. Effects of a new calcium sensitizer, levosimendan, on haemodynamics, coronary blood flow and myocardial substrate utilization early after coronary artery bypass grafting. Eur Heart J