
| 10.1155/2018/7563083
http://scihub22266oqcxt.onion/10.1155/2018/7563083
 C5964575!5964575
!29854789
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free
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Biomed+Res+Int
2018 ; 2018
(�): 7563083
Nephropedia Template TP
gab.com Text
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English Wikipedia
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Levosimendan in Patients with Left Ventricular Dysfunction Undergoing Cardiac
Surgery: An Update Meta-Analysis and Trial Sequential Analysis
#MMPMID29854789
Wang B
; He X
; Gong Y
; Cheng B
Biomed Res Int
2018[]; 2018
(�): 7563083
PMID29854789
show ga
BACKGROUND: Recent studies suggest that levosimendan does not provide mortality
benefit in patients with low cardiac output syndrome undergoing cardiac surgery.
These results conflict with previous findings. The aim of the current study is to
assess whether levosimendan reduces postoperative mortality in patients with
impaired left ventricular function (mean EF ? 40%) undergoing cardiac surgery.
METHODS: We conducted a comprehensive search of PubMed, EMBASE, and Cochrane
Library Database through November 20, 2017. Inclusion criteria were random
allocation to treatment with at least one group receiving levosimendan and
another group receiving placebo or other treatments and cardiac surgery patients
with a left ventricular ejection fraction of 40% or less. The primary endpoint
was postoperative mortality. Secondary outcomes were cardiac index, pulmonary
capillary wedge pressure (PCWP), length of intensive care unit (ICU) stay,
postoperative atrial fibrillation, and postoperative renal replacement therapy.
We performed trial sequential analysis (TSA) to evaluate the reliability of the
primary endpoint. RESULTS: Data from 2,152 patients in 15 randomized clinical
trials were analyzed. Pooled results demonstrated a reduction in postoperative
mortality in the levosimendan group [RR = 0.53, 95% CI (0.38-0.73), I(2) = 0].
However, the result of TSA showed that the conclusion may be a false positive.
Secondary outcomes demonstrated that PCWP, postoperative renal replacement
therapy, and length of ICU stay were significantly reduced. Cardiac index was
greater in the levosimendan group. No difference was found in the rate of
postoperative atrial fibrillation. CONCLUSIONS: Levosimendan reduces the rate of
death and other adverse outcomes in patients with low ejection fraction who were
undergoing cardiac surgery, but results remain inconclusive. More large-volume
randomized clinical trials (RCTs) are warranted.
|Cardiac Output, Low/drug therapy/surgery
[MESH]|Cardiac Surgical Procedures/methods
[MESH]|Cardiotonic Agents/*therapeutic use
[MESH]|Humans
[MESH]|Hydrazones/*therapeutic use
[MESH]|Postoperative Complications/prevention & control
[MESH]|Pyridazines/*therapeutic use
[MESH]|Randomized Controlled Trials as Topic
[MESH]|Renal Replacement Therapy
[MESH]|Simendan
[MESH]
  
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