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ABSTRACT: Background
Previous studies on whether or not levosimendan improved the prognosis of patients with sepsis and septic shock have been inconsistent. We aimed to provide an updated analysis of the therapeutic value of levosimendan in adult patients with sepsis and septic shock, in order to provide evidence-based medical evidence for its use.Methods
PubMed, Embase, Cochrane Library, Wanfang Data, and CNKI were searched until August 2018 without language restriction. Randomized controlled studies of levosimendan with either inotropic drugs or placebo for the treatment of sepsis or septic shock were enrolled. The primary outcome was mortality, and cardiac index and serum lactate levels were the secondary outcomes.Results
A total of 20 randomized controlled studies were included in this meta-analysis, including 1467 patients, with 738 patients in the experimental group (levosimendan group) and 729 patients in the control group (other inotropic drugs or placebo). There were no significant differences in mortality between the levosimendan and control groups (fixed-effect relative risk [RR]?=?0.90, 95% confidence interval [CI] [0.79, 1.03], P?=?0.13). Levosimendan increased the cardiac index (VMD [weighted mean difference]?=?0.51, 95% CI [0.06, 0.95], P?=?0.02); and serum lactate levels were lower (VMD?=?-1.04, 95% CI [-1.47, -0.60], P?ConclusionsBased on current clinical evidence, levosimendan does not reduce mortality in adult critically ill patients with sepsis and septic shock. Physicians should use levosimendan with caution in patients with sepsis and septic shock.
SUBMITTER: Feng F
PROVIDER: S-EPMC6511414 | biostudies-literature | 2019 May
REPOSITORIES: biostudies-literature
Feng Fang F Chen Yu Y Li Min M Yuan Jiao-Jiao JJ Chang Xue-Ni XN Dong Chen-Ming CM
Chinese medical journal 20190501 10
<h4>Background</h4>Previous studies on whether or not levosimendan improved the prognosis of patients with sepsis and septic shock have been inconsistent. We aimed to provide an updated analysis of the therapeutic value of levosimendan in adult patients with sepsis and septic shock, in order to provide evidence-based medical evidence for its use.<h4>Methods</h4>PubMed, Embase, Cochrane Library, Wanfang Data, and CNKI were searched until August 2018 without language restriction. Randomized contro ...[more]