Levosimendan in Cardiac Surgery复制标题

左西孟旦在心脏手术中的应用

The trial by Landoni et al. randomly assigned cardiac-surgery patients with postoperative cardiovascular dysfunction to receive levosimendan or placebo. The trial showed no significant beneficial effects on postoperative outcome, similar to the findings of the trial by Mehta et al. (May 25 issue). In the latter trial (Levosimendan in Patients with Left Ventricular Systolic Dysfunction Undergoing Cardiac Surgery Requiring Cardiopulmonary Bypass [LEVO-CTS]), levosimendan was administered just after anesthesia induction to patients with preoperative cardiac dysfunction. Pharmacokinetic and pharmacodynamic studies suggest that the steady-state concentration of levosimendan is reached within 4 to 8 hours after initiation of the infusion and remains constant over a period of 24 hours.Active plasma metabolites can be detected after 12 hours, with a peak in 48 to 78 hours; such metabolites contribute further to the hemodynamic effects of the drug.

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