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The Efficacy of Levosimendan Infusion on Hemodynamic Improvement in Patient Cardiogenic Shock (CS) after Percutaneous Coronary Intervention (PCI) or Intraaortic Balloon Pump (IABP) : a Mini Systematic Review

Author : M. D. Jalma, W. Rahmadhani, J. M. Siahaan
Upload Date : 19-04-2018

Background: Levosimendan is a new calcium sensitizer with positive inotropic properties, has been shown to improve hemodynamic function in patients Cardiogenic Shock (CS) after Percutaneous Coronary Intervention (PCI) or Intraaortic Balloon Pump (IABP). Levosimendan infusion in cardiogenic shock improved cardiovascular hemodynamics without leading to hypotension. Furthermore, these effects may also be responsible for the lower incidence of early organ dysfunction in levosimendan-treated patients.

Objectives: To understand the haemodynamic effects of levosimendan in patients Cardiogenic Shock (CS) after Percutaneous Coronary Intervention (PCI) or Intraaortic Balloon Pump (IABP)

Method: Structured searches were conducted on PUBMED, ELSEVIER, SCHOLAR database on January 2018 using “Levosimendan”, “Cardiogenic Shock”, “Percutaneous Coronary Intervention”, and “Intraaortic Balloon Pump (IABP)” as keywords. A randomized controlled trial of levosimendan was included and any conditions that affect and duration of CS longer than 24 hrs before PCI or IABP were excluded.

Result: During initial search results, 92 studies were found. After removing duplicates and screening title and abstracts, 3 studies remain. Six teen studies exclusion criterion was hypotension related to any mechanical complications of CS and without PCI or IABP. The remaining three studies comprising of 52 subjects were all included and analyze accordingly.

Conclusion: Levosimendan added to current therapy may contribute to improved survival, and was achieved better by the end of the 24 hours. Levosimendan infusion in following cardiogenic shock improved cardiovascular hemodynamics without leading to hypotension. Hemodynamic improvement was sustained after levosimendan infusion was stopped. Levosimendan could be a better choice than dobutamine as inotropic therapy for patients with cardiogenic shock.

KEYWORDS : Levosimendan, Cardiogenic Shock (CS), Percutaneous Coronary Intervention (PCI), and Intraaortic Balloon Pump (IABP)


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