[Levosimendan in patients with acute cardiac failure].
OBJECTIVE
To assess levosimendan efficacy in acute cardiac failure.


METHODS
We included 25 patients with acute cardiac failure and partial conventional therapy response defined as persistence of low cardiac output with inotropic support. We started levosimendan at loading dose and continuous infusion for 24 hours, recording hemodynamic data, as well as clinical variables.


RESULTS
All patients showed clinical and hemodynamic improvement. Pulmonary wedge capillary pressure (PWCP) decreased from 18 cmH2O (11-30 cmH2O) to 14 cmH2O (8-15 cmH2O) at 12 hours (p = 0.3) and to 13 cmH2O (8-12 cmH2O) at the end of the infusion period (p = 0.2). Cardiac index increased from 2.1 L/min/m2 (1.8-3.5 L/ min/m2) to 2.86 L/min/m2 (2-4.3 L/min/m2) at 12 hours (p = 0.03) and to 3.08 L/min/m2 at the end of the infusion period (p = 0.02). Tachycardia higher than 120 bpm was present in six patients. No major hypotensive events were present. Mortality to the present is of eight patients.


CONCLUSIONS
Levosimendan infusion improved hemodynamics and clinical variables in acute cardiac failure with few side effects in this small series of patients.
García Graullera
Roberto de Jesús
Rde J
Departamento de Medicina Crítica "Dr. Mario Shapiro", ABC Medical Center, México, DF.
Sánchez Mécatl
Miguel Angel
MA
Cerda García
Paul
P
Torreblanca Marín
Mario
M
Aguirre Sánchez
Janet Silvia
JS
Martínez Sánchez
Jesús
J
D000208:Acute Disease; D000368:Aged; D002303:Cardiac Output, Low / Q000188:drug therapy*; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006835:Hydrazones / Q000627:therapeutic use*; D008297:Male; D011724:Pyridazines / Q000627:therapeutic use*; D000077464:Simendan
D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan