title: Experiences of levosimendan as an inotropic agent in conjunction with passive containment surgery.
abstract: OBJECTIVE
  Levosimendan is a calcium sensitizer with a positive inotropic effect without increasing oxygen consumption. We have evaluated the immediate effects of levosimendan on cardiac index when given peri-operatively to patients with dilated cardiomyopathy in conjunction with passive containment surgery.
  
  
  METHODS
  Ten patients with dilated cardiomyopathy undergoing passive containment surgery with the ACORN Cardiac Support Device, either as the sole procedure or in combination with other open heart surgery, were after anaesthesia induction given levosimendan as a bolus dose of 12 microg/kg followed by an infusion of 0.1microg/kg/min for 24 hours. Cardiac index were measured before extra corporal circulation, immediately after extra corporal circulation, at arrival to the intensive care unit and on post operative day 1. The need for inotropic support was recorded.
  
  
  RESULTS
  Nine of ten patients were preoperatively in a low cardiac output situation. At postoperative day 1 there was a significant increase in cardiac index from 2.1+/-0.1 to 2.8+/-0.2.
  
  
  CONCLUSIONS
  This study confirms the theoretical benefits of levosimendan judged by an immediate significant positive effect on cardiac index.
authors.affiliation: Department of Cardiothoracic Surgery & Anesthesiology, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden. fredrik.bredin@karolinska.se
authors.forename: Fredrik
authors.initials: F
authors.lastname: Bredin
authors.forename: Anders
authors.initials: A
authors.lastname: Franco-Cereceda
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects*; D006348:Cardiac Surgical Procedures; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006353:Heart-Assist Devices; D006801:Humans; D006835:Hydrazones / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011724:Pyridazines / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D000077464:Simendan; D016896:Treatment Outcome
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan