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  • Poster presentation
  • Open Access

Hemodynamic and volumetric response to levosimendan in critical care patients

  • 1,
  • 2 and
  • 1
Critical Care20048 (Suppl 1) :P84

https://doi.org/10.1186/cc2551

  • Published:

Keywords

  • Congestive Heart Failure
  • Cardiac Index
  • Cardiogenic Shock
  • Pulmonary Capillary Wedge Pressure
  • Filling Pressure

Introduction

Levosimendan (LS), a new inodilator, improves survival in patients with congestive heart failure, but data on critical care patients with cardiorespiratory failure are scanty [1]. The aim of this study is to evaluate the homodynamic and volumetric response to LS in critical care patients with cardiogenic shock.

Materials and methods

Ten critical care patients with cardiogenic shock were studied. All patients were mechanically ventilated and connected to an integrated monitoring system (PICCO system/Agilent) by a fiberoptic arterial catheter (pv 2014L16) and by a Swan–Ganz catheter. At basal time (T0) and at 1 hour (T1), 6 hours (T2), 12 hours (T3), 24 hours (T4) during LS infusion and at 12 hours post LS suspension (T5), the main haemodynamic and volumetric data were studied. All data are expressed as mean ± SD. The ANOVA test for RM was used to compare changes during times study.

Results

Table 1 presents the main hemodynamic changes of cardiac output (CO), pulmonary capillary wedge pressure (PCWP), intrathoracic blood volume (ITBVI) and extravascular lung water (EVLWI).

Table 1

Parameter

T0

T1

T2

T3

T4

T5

CO

3.7 ± 0.9

4.9 ± 1.2*

4.8 ± 1.1

4.5 ± 1.8

4.7 ± 0.7

5.5 ± 1.3**

PCWP

19.8 ± 5

12.4 ± 3**

11.4 ± 3***

11.3 ± 2***

12.1 ± 2***

11.3 ± 0.9***

ITBVI

831 ± 34

782 ± 123

882 ± 146

715 ± 115*

842 ± 84

857 ± 110

EVLWI

14.1 ± 9

12 ± 7

11.8 ± 7

9.4 ± 3

9.1 ± 3

8 ± 0.9*

*P < 0.05 vs basal time. **P < 0.01 vs basal time. ***P < 0.001 vs basal time.

Conclusions

(1) LS increases the cardiac index and improves filling pressures in critical care patients. (2) This improvement correlates with decreasing of ITBVI and lung edema. (3) A haemodynamic effect is maintained after LS infusion: this may be useful during rapid weaning from ventilatory support.

Authors’ Affiliations

(1)
S. Eugenio Hospital, Rome, Italy
(2)
Tor Vergata University, Rome, Italy

References

  1. Kart GD: Acta Anesthesiol Scand 2003, 47: 1251-1256. 10.1046/j.1399-6576.2003.00252.xView ArticleGoogle Scholar

Copyright

© BioMed Central Ltd. 2004

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