CLINICAL RESEARCH e-ISSN 1643-3750 © Med Sci Monit, 2016; 22: 1486-1496 DOI: 10.12659/MSM.898457
Levosimendan Versus Dobutamine in Myocardial Injury Patients with Septic Shock: A Randomized Controlled Trial
Received: 2016.03.11 Accepted: 2016.04.05 Published: 2016.05.03
Authors’ Contribution: Study Design A Data Collection B Analysis C Statistical Data Interpretation D Manuscript Preparation E Literature Search F Collection G Funds
ABCDEF 1 ABDG 1 ABCDF 1 ABE 1 BC 1 AE 1 B 2
Jian-biao Meng* Ma-hong Hu* Zhi-zhen Lai* Chun-lian Ji Xiu-juan Xu Geng Zhang Shuyuan Tian
1 Department of Intensive Care Unit, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejang, P.R. China 2 Department of Ultrasonography, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejang, P.R. China
Corresponding Author: Source of support:
* Jian-biao Meng, Ma-hong Hu, and Zhi-zhen Lai contributed equally to this work Geng Zhang, e-mail:
[email protected] Financial support for this research was provided by the Science and Technology Department of Zhejiang Province, China (2013C33198
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We aimed to investigate the effect of levosimendan on biomarkers of myocardial injury and systemic hemodynamics in patients with septic shock. After achieving normovolemia and a mean arterial pressure of at least 65 mmHg, 38 septic shock patients with low cardiac output (left ventricular ejective fraction), LEVF £45%) were randomly divided into two groups: levosimendan dobutamine. Patients in the levosimendan and dobutamine groups were maintained with intravenous infusion of levosimendan (0.2 μg/kg/minute) and dobutamine (5 μg/kg/minute) for 24 hours respectively. During treatment we monitored hemodynamics and LVEF, and measured levels of heart-type fatty acid binding protein (HFABP), troponin I (TNI), and brain natriuretic peptide(BNP). In addition, the length of mechanical ventilation, intensive care unit (ICU) stay, hospital stay, and 28-day mortality were compared between the two groups. The levosimendan group and the dobutamine group were well matched with respect to age (years, 55.4±1 7.5 versus 50.2±13.6) and gender (males, 68.4% versus 57.9%). Levosimendan-treated patients had higher stroke volume index (SVI), cardiac index (CI), LVEF, and left ventricular stroke work index (LVSWI), and lower extravascular lung water index (EVLWI) compared to dobutamine-treated patients (p
