PMID- 32677985
OWN - NLM
STAT- MEDLINE
DCOM- 20210414
LR  - 20210414
IS  - 1466-609X (Electronic)
IS  - 1364-8535 (Print)
IS  - 1364-8535 (Linking)
VI  - 24
IP  - 1
DP  - 2020 Jul 16
TI  - Can levosimendan reduce ECMO weaning failure in cardiogenic shock?: a cohort 
      study with propensity score analysis.
PG  - 442
LID - 10.1186/s13054-020-03122-y [doi]
LID - 442
AB  - BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been 
      increasingly used over the last decade in patients with refractory cardiogenic 
      shock. ECMO weaning can, however, be challenging and lead to circulatory failure 
      and death. Recent data suggest a potential benefit of levosimendan for ECMO 
      weaning. We sought to further investigate whether the use of levosimendan could 
      decrease the rate of ECMO weaning failure in adult patients with refractory 
      cardiogenic shock. METHODS: We performed an observational single-center cohort 
      study. All patients undergoing VA-ECMO from January 2012 to December 2018 were 
      eligible and divided into two groups: group levosimendan and group control 
      (without levosimendan). The primary endpoint was VA-ECMO weaning failure defined 
      as death during VA-ECMO treatment or within 24 h after VA-ECMO removal. Secondary 
      outcomes were mortality at day 28 and at 6 months. The two groups were compared 
      after propensity score matching. P < 0.05 was considered statistically 
      significant. RESULTS: Two hundred patients were analyzed (levosimendan group: 
      n = 53 and control group: n = 147). No significant difference was found between 
      groups on baseline characteristics except for ECMO duration, which was longer in 
      the levosimendan group (10.6 +/- 4.8 vs. 6.5 +/- 4.7 days, p < 0.001). Levosimendan 
      administration started 6.6 +/- 5.4 days on average following ECMO implantation. 
      After matching of 48 levosimendan patients to 78 control patients, the duration 
      of ECMO was similar in both groups. The rate of weaning failure was 29.1% and 
      35.4% in levosimendan and control groups, respectively (OR: 0.69, 95%CI: 
      0.25-1.88). No significant difference was found between groups for all secondary 
      outcomes. CONCLUSION: Levosimendan did not improve the rate of successful VA-ECMO 
      weaning in patients with refractory cardiogenic shock. TRIAL REGISTRATION: 
      ClinicalTrials.gov, NCT04323709 .
FAU - Guilherme, Enrique
AU  - Guilherme E
AUID- ORCID: 0000-0001-9261-1682
AD  - Hospices Civils de Lyon, Hopital Louis Pradel, Service d'Anesthesie-Reanimation, 
      Lyon, France.
FAU - Jacquet-Lagreze, Matthias
AU  - Jacquet-Lagreze M
AD  - Hospices Civils de Lyon, Hopital Louis Pradel, Service d'Anesthesie-Reanimation, 
      Lyon, France. matthias.jacquet-lagreze@chu-lyon.fr.
AD  - INSERM U1060, Laboratoire CarMeN, IHU OPeRa, Lyon, France. 
      matthias.jacquet-lagreze@chu-lyon.fr.
FAU - Pozzi, Matteo
AU  - Pozzi M
AD  - Hospices Civils de Lyon, Hopital Louis Pradel, Service de Chirurgie Cardiaque, 
      Lyon, France.
FAU - Achana, Felix
AU  - Achana F
AD  - Nuffield Department of Primary care, Oxford University, Oxford, UK.
FAU - Armoiry, Xavier
AU  - Armoiry X
AD  - Lyon School of Pharmacy (ISPB), Public Health department/UMR CNRS 5510 MATEIS, 
      I2B Team, Lyon, France.
AD  - Division of Health Sciences, Warwick Medical School, Warwick university, 
      Coventry, UK.
FAU - Fellahi, Jean-Luc
AU  - Fellahi JL
AD  - Hospices Civils de Lyon, Hopital Louis Pradel, Service d'Anesthesie-Reanimation, 
      Lyon, France.
AD  - INSERM U1060, Laboratoire CarMeN, IHU OPeRa, Lyon, France.
LA  - eng
SI  - ClinicalTrials.gov/NCT04323709
PT  - Journal Article
PT  - Observational Study
DEP - 20200716
PL  - England
TA  - Crit Care
JT  - Critical care (London, England)
JID - 9801902
RN  - 0 (Cardiotonic Agents)
RN  - 349552KRHK (Simendan)
SB  - IM
EIN - Crit Care. 2020 Aug 5;24(1):487. PMID: 32758275
MH  - Adult
MH  - Aged
MH  - Cardiotonic Agents/pharmacology/therapeutic use
MH  - Cohort Studies
MH  - Extracorporeal Membrane Oxygenation/methods/standards/statistics & numerical data
MH  - Female
MH  - France
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Propensity Score
MH  - Shock, Cardiogenic/*drug therapy
MH  - Simendan/*pharmacology/therapeutic use
MH  - Ventilator Weaning/methods/*standards/statistics & numerical data
PMC - PMC7367381
OTO - NOTNLM
OT  - Cardiogenic shock
OT  - Circulatory failure
OT  - ECMO weaning failure
OT  - Levosimendan
OT  - VA-ECMO
COIS- JLF is a member of an advisory board working for ORION Pharma France and has 
      received honoraria from the company for his participation in the board.
EDAT- 2020/07/18 06:00
MHDA- 2021/04/15 06:00
PMCR- 2020/07/16
CRDT- 2020/07/18 06:00
PHST- 2020/05/06 00:00 [received]
PHST- 2020/06/29 00:00 [accepted]
PHST- 2020/07/18 06:00 [entrez]
PHST- 2020/07/18 06:00 [pubmed]
PHST- 2021/04/15 06:00 [medline]
PHST- 2020/07/16 00:00 [pmc-release]
AID - 10.1186/s13054-020-03122-y [pii]
AID - 3122 [pii]
AID - 10.1186/s13054-020-03122-y [doi]
PST - epublish
SO  - Crit Care. 2020 Jul 16;24(1):442. doi: 10.1186/s13054-020-03122-y.