Overview of the current use of levosimendan in France: a prospective observational cohort study

Annals of Intensive Care

Research

Bruno Levy¹  François Roubille²  Clément Delmas³  Pascal Lim⁴  François Labaste⁵  David Tonon⁶  Bertrand Rozec⁷  Emmanuel Besnier⁸  Bernard Cholley⁹  Mathieu Mattei^1,10  Benoit Guillon^1,11  Jean-Luc Fellahi^1,12  Philippe Mauriat^1,13  Nadir Tafer^1,14  Alexandre Ouattara^1,14  Thibaut Caruba^1,15  Mirela Bojan^1,16 

[1] CHRU Nancy, Critical Care, CHRU de Nancy, Hôpital de Brabois, Vandoeuvre-Les Nancy, France;Cardiology Department INI-CRT PhyMedExp INSERM, CNRS CHU de Montpellier, Université de Montpellier, Montpellier, France;Cardiology Department, Rangueil University Hospital, Toulouse, France;Cardiology department, Henri-Mondor University Hospital, AP-HP, Créteil, France;Department of Anaesthesiology and Critical Care Medicine, Rangueil University Hospital, Toulouse, France;Department of Anaesthesiology and Critical Care Medicine, University Hospital Timone, AP-HM, Aix-Marseille University, 13385, Marseille CEDEX 05, France;Department of Anaesthesiology and Critical Care, Institut du Thorax, Laennec Hospital, CHU de Nantes, and Nantes Université, CHU Nantes*, CNRS, INSERM, 44000, Nantes, France;Department of Anaesthesiology and Critical Care, Normandie Univ, UNIROUEN, INSERM U1096, CHU Rouen, 76000, Rouen, France;Department of Anaesthesiology and Intensive Care Medicine, Hôpital Européen Georges Pompidou, AP-HP, 75015, Paris, France;Université Paris Cité, INSERM, UMR_S 1140 “Innovations Thérapeutiques en Hémostase”, 75006, Paris, France;Department of Cardiology and Cardiac Surgery, CHRU de Nancy, Hôpital de Brabois, Vandoeuvre-les Nancy, France;Department of Cardiology, University Hospital Besancon, Besançon, France;Department of Cardiothoracic Anaesthesiology and Critical Care, Louis Pradel University Hospital, Lyon, France;Department of Cardiovascular Anesthesia and Critical Care, CHU Bordeaux, CHU de Bordeaux, 33000, Bordeaux, France;Department of Cardiovascular Anesthesia and Critical Care, CHU Bordeaux, CHU de Bordeaux, 33000, Bordeaux, France;Biology of Cardiovascular Diseases, Université de Bordeaux, INSERM, U1034, 33600, Pessac, France;Department of Pharmacy, Hôpital Européen Georges Pompidou, AP-HP, Paris, France;Pôle Cardiopathies Congénitales, Hôpital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, 92350, Le Plessis-Robinson, France;

关键词: Levosimendan;    Inotropes;    Heart failure;    Cardiogenic shock;    Repetitive infusions;    VA-ECMO weaning;   

DOI  :  10.1186/s13613-023-01164-3

 received in 2023-03-24, accepted in 2023-07-11,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundFollowing the results of randomized controlled trials on levosimendan, French health authorities requested an update of the current use and side-effects of this medication on a national scale.MethodThe France-LEVO registry was a prospective observational cohort study reflecting the indications, dosing regimens, and side-effects of levosimendan, as well as patient outcomes over a year.ResultsThe patients included (n = 602) represented 29.6% of the national yearly use of levosimendan in France. They were treated for cardiogenic shock (n = 250, 41.5%), decompensated heart failure (n = 127, 21.1%), cardiac surgery-related low cardiac output prophylaxis and/or treatment (n = 86, 14.3%), and weaning from veno-arterial extracorporeal membrane oxygenation (n = 82, 13.6%). They received 0.18 ± 0.07 µg/kg/min levosimendan over 26 ± 8 h. An initial bolus was administered in 45 patients (7.5%), 103 (17.1%) received repeated infusions, and 461 (76.6%) received inotropes and or vasoactive agents concomitantly. Hypotension was reported in 218 patients (36.2%), atrial fibrillation in 85 (14.1%), and serious adverse events in 17 (2.8%). 136 patients (22.6%) died in hospital, and 26 (4.3%) during the 90-day follow-up.ConclusionsWe observed that levosimendan was used in accordance with recent recommendations by French physicians. Hypotension and atrial fibrillation remained the most frequent side-effects, while serious adverse event potentially attributable to levosimendan were infrequent. The results suggest that this medication was safe and potentially associated with some benefit in the population studied.

【 授权许可】

CC BY   
© La Société de Réanimation de Langue Francaise = The French Society of Intensive Care (SRLF) 2023

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