Perioperative Application of Levosimendan Optimizes Postoperative Renal Function and Organ Perfusion in Patients with Severe Heart Failure

Author:

Leivaditis Vasileios1ORCID,Dahm Manfred1,Papaporfyriou Anastasia2,Galanis Michail3ORCID,Koletsis Efstratios4ORCID,Charokopos Nikolaos4,Ehle Benjamin5,Papatriantafyllou Athanasios6,Haussmann Erich1,Kaplunov Vladislav1,Grapatsas Konstantinos7

Affiliation:

1. Department of Cardiothoracic and Vascular Surgery, Westpfalz-Klinikum, 67655 Kaiserslautern, Germany

2. Department of Pulmonology, Internal Medicine II, Vienna University Hospital, 1090 Vienna, Austria

3. Department of Thoracic Surgery, Inselspital, Bern University Hospital, University of Bern, 3012 Bern, Switzerland

4. Department of Cardiothoracic Surgery, University Hospital of Patras, 26504 Patras, Greece

5. Department of Thoracic Surgery, Asklepios Lung Clinic Munich-Gauting, 82131 Gauting, Germany

6. Department of General Surgery, General Hospital of Patras “Agios Andreas”, 26332 Patras, Greece

7. West German Lung Center, Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, University Hospital Essen, University Duisburg-Essen, 45239 Essen, Germany

Abstract

Background: Renal dysfunction and impaired organ perfusion are common concerns following cardiac surgery. Levosimendan, a calcium sensitizer inotropic drug, is investigated in this study for its potential to improve postoperative renal function and organ perfusion in patients with low preoperative ejection fraction and severe myocardial dysfunction after cardiac surgery. Methods: A retrospective analysis was conducted on 314 patients with preoperative heart failure who underwent cardiac surgery. Among them, 184 patients received perioperative adjunctive therapy with levosimendan, while 130 patients with similar characteristics received conventional treatment. Results: The perioperative administration of levosimendan resulted in a significantly lower need for renal replacement therapy (p < 0.001) and improvements in the serum creatinine levels, glomerular filtration rate, and creatinine clearance. Similarly, the C-reactive protein levels, blood pH, and lactic acid levels showed comparable improvements. Conclusions: The use of levosimendan was associated with a significant enhancement in postoperative renal function and a reduction in the need for renal replacement therapy. Furthermore, it resulted in a decrease in the extent of organ malperfusion. Postoperative inflammatory reactions and metabolic balance also exhibited improvements.

Publisher

MDPI AG

Subject

Pharmacology (medical),General Pharmacology, Toxicology and Pharmaceutics

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