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Ecmo levosimendan

R Prondzinsky, H Lemm, A Geppert, M Buerke, M Russ, K Werdan
Patients with ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI) experience cardiogenic shock in about 6-10% of cases during the hospital treatment. In recent years, the incidence seems to be decreasing due to invasive diagnostics and therapy after myocardial infarction. Early diagnosis is important to initiate immediate revascularization using percutaneous coronary intervention (PCI) with stent implantation as part of cardiogenic shock treatment. Thus, a significant improvement in survival can be achieved...
May 2, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
K Distelmaier, C Roth, L Schrutka, C Binder, B Steinlechner, G Heinz, I M Lang, G Maurer, H Koinig, A Niessner, M Hülsmann, W Speidl, G Goliasch
BACKGROUND: The impact of levosimendan treatment on clinical outcome in patients undergoing extracorporeal membrane oxygenation (ECMO) support after cardiovascular surgery is unknown. We hypothesized that the beneficial effects of levosimendan might improve survival when adequate end-organ perfusion is ensured by concomitant ECMO therapy. We therefore studied the impact of levosimendan treatment on survival and failure of ECMO weaning in patients after cardiovascular surgery. METHODS: We enrolled a total of 240 patients undergoing veno-arterial ECMO therapy after cardiovascular surgery at a university-affiliated tertiary care centre into our observational single-centre registry...
July 2016: British Journal of Anaesthesia
Amy C Chan-Dominy, Sarfaraz N Rahiman, Marc Anders, Warwick Butt
BACKGROUND: Patients with severe portopulmonary hypertension (PoPH) responsive to medical therapy may be considered for liver transplantation. We present a case of extracorporeal membrane oxygenation (ECMO) resuscitation for PoPH crisis in a child following liver transplantation (LT), and review the literature on management of this challenging setting. CASE REPORT: A 7-year-old girl, with previous Kasai portoenterostomy and subsequent severe PoPH responsive to pulmonary vasodilator therapy, underwent orthotopic LT...
June 2015: International Journal of Artificial Organs
P Feltracco, C Carollo, C Ori
No abstract text is available yet for this article.
January 2015: Minerva Anestesiologica
Alessandro Affronti, Isidoro di Bella, Davide Carino, Temistocle Ragni
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides temporary mechanical circulatory support in patients with refractory cardiogenic shock, allowing time for cardiac recovery. Levosimendan is a calcium sensitizer with inotropic and vasodilatory effects used in the treatment of severe heart failure. It does not increase myocardial oxygen consumption. Its maximum hemodynamic response is seen 24-48 h after stopping infusion, but its effects can persist for 7-9 d owing to active metabolites. We sought to investigate whether the use of levosimendan improves weaning outcomes in patients on VA-ECMO...
November 2013: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Hans D Theiss, Ulrich Grabmaier, Nicole Kreissl, Christian Hagl, Gerhard Steinbeck, Ralf Sodian, Wolfgang-M Franz, Ingo Kaczmarek
In this retrospective study, we investigated the impact of preconditioning of the right ventricle with the calcium sensitizer levosimendan immediately before left ventricular assist device (LVAD) implantation on outcome and survival. Nine consecutive LVAD patients (seven suffering from dilative cardiomyopathy and two from ischemic cardiomyopathy) with echocardiographic and invasive evidence of right heart insufficiency received levosimendan with 0.1 μg/kg body weight/min for 24 h before implantation of the assist device (seven HeartWare and two Jarvik 2000)...
March 2014: Artificial Organs
(no author information available yet)
The experience of the federal medical center of the surgical treatment of small patients with the anomalous origin of the left coronary artery from the pulmonary trunk was analyzed. The early surgical treatment, directed at the reconstruction of the two sources of myocardial blood supply together with the standard use of "calcium sensitizer" ("Levosimendan") decrease the lethality to 6.6% without the use of extracorporeal membrane oxygenation. The restoration of the ischemized left ventricle after the correction and improvement of the concomitant mitral valve insufficiency were dynamically assessed in early postoperative terms...
2013: Khirurgiia
Ulrich Schweigmann, Corinna Velik-Salchner, Juliane Kilo, Elisabeth Schermer
During the past 3 years, seven potential candidates for mechanical circulatory support (MCS) were treated at our center. Ultimately, only one of them needed MCS (extracorporeal membrane oxygenation [ECMO] for 16 days), although 5 years earlier, all would have been considered for MCS at our center. Seven consecutive patients were seen in this period: four toddlers (three suffering from fulminant myocarditis and one with dilated cardiomyopathy associated with spongy myocardium) and three adolescents (two with postmyocarditis cardiomyopathy and one with hypertrophic cardiomyopathy and severe restrictive dysfunction after an ischemic event with cardiopulmonary resuscitation [stunned heart])...
November 2011: Artificial Organs
Lindsay M Ryerson, Roberto Chiletti, Margaret Zacharin, James Tibballs
We present the clinical course and management of two infants with idiopathic infantile arterial calcification. Both had coronary artery involvement and presented with ischaemic cardiac failure. Neither responded well to conventional therapy with inotropic agents, glyceryl trinitrate, diuretic and mechanical ventilation, nor to short-term biphosphonates. One was treated with levosimendan and extracorporeal membrane oxygenation to no avail.
December 2010: Journal of Paediatrics and Child Health
A Beiras-Fernandez, F C Weis, F Kur, I Kaczmarek, M Schmoeckel, M Weis, B Reichart
Primary organ failure after heart transplantation is a severe complication generally related to prolonged ischemia time, poor quality of the organ, or rejection. Ca(2+) sensitisers increase cardiac contractility without altering intracellular Ca(2+) levels. Our aim was to evaluate the influence of levosimendan in the therapy of primary failure after heart transplantation. Five patients presenting with reduced ejection fraction (EF<30%) and high dosed catecholamines after heart transplantation were treated with levosimendan (Simdax, Abbot GesmbH, Vienna, Austria) in a 24-hour continuous infusion (0...
May 2008: Transplantation Proceedings
J J Krumnikl, W G Toller, G Prenner, H Metzler
BACKGROUND: Administration of high doses of prostaglandins is a frequently performed and effective method for the treatment of atonic uterine haemorrhage in order to increase uterine muscle tone. Rarely, however, these drugs may cause life-threatening complications including bronchospasm, acute pulmonary oedema and myocardial infarction caused by coronary spasms. METHODS: We discuss the management of a patient suffering post-partum atonic uterine bleeding, catecholamine-resistant cardiac arrest and fulminant pulmonary failure due to deleterious side-effects of treatment with prostaglandins...
July 2006: Acta Anaesthesiologica Scandinavica
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