title: Effect of levosimendan on hemodynamic changes in patients undergoing off-pump coronary artery bypass grafting: a randomized controlled study.
abstract: OBJECTIVE
  We tested the hypothesis that use of levosimendan would be associated with better perioperative hemodynamics and cardiac function during off-pump coronary artery bypass grafting (OPCAB) in patients with good left ventricular function.
  
  
  METHODS
  Thirty patients scheduled for OPCAB were randomized in a double-blind manner to receive either levosimendan 0.1 μg/kg/min or placebo after induction of general anesthesia. The hemodynamic variables were measured after induction of anesthesia, at 6 minute after application of tissue stabilizer for the anastomoses of left anterior descending artery, diagonal artery, left circumflex artery, and right coronary artery and at 6, 12, 18, and 24 hours after completion of surgery.
  
  
  RESULTS
  Compared with placebo group, cardiac index (CI) was significantly higher and systemic vascular resistance index (SVRI) was significantly lower at 6, 12, 18, and 24 hour after surgery in levosimendan group. Norepinephrine was infused in 60% of the patients in the levosimendan group compared to 6.7% in the control group ( P < 0.05). Lactate and mixed venous oxygen saturation were not significantly different between groups.
  
  
  CONCLUSIONS
  Levosimendan significantly increased CI and decreased SVRI after OPCAB but it did not show any outcome benefit in terms of duration of ventilation and intensive care unit stay.
authors.affiliation: Department of Cardiac Anesthesiology, Sri Ramachandra Medical College and Research Institute, Porur, Chennai,Tamil Nadu, India.
authors.forename: Rajesh Kumar
authors.initials: RK
authors.lastname: Kodalli
authors.forename: Ayya Syama
authors.initials: AS
authors.lastname: Sundar
authors.forename: Mahesh
authors.initials: M
authors.lastname: Vakamudi
authors.forename: Harish
authors.initials: H
authors.lastname: Ravulapali
authors.forename: Sushma
authors.initials: S
authors.lastname: Nandipati
authors.forename: Nivash
authors.initials: N
authors.lastname: Chandrasekaran
authors.forename: Ranjith Baskar
authors.initials: RB
authors.lastname: Karthekeyan
mesh_terms: D002118:Calcium / Q000378:metabolism; D002316:Cardiotonic Agents / Q000494:pharmacology*; D047549:Coronary Artery Bypass, Off-Pump; D004311:Double-Blind Method; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006835:Hydrazones / Q000494:pharmacology*; D008297:Male; D011724:Pyridazines / Q000494:pharmacology*; D000077464:Simendan
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan; D002118:Calcium