Preoperative levosimendan decreases mortality and the development of low cardiac output in high-risk patients with severe left ventricular dysfunction undergoing coronary artery bypass grafting with cardiopulmonary bypass.

Background: The calcium sensitizer levosimendan has been used in cardiac surgery for the treatment of postoperative low cardiac output syndrome (LCOS) and difficult weaning from cardiopulmonary bypass (CPB).

Objectives: To evaluate the effects of preoperative treatment with levosimendan on 30-day mortality, the risk of developing LCOS and the requirement for inotropes, vasopressors and intra-aortic balloon pumps in patients with severe left ventricular dysfunction.

Methods: Patient with severe left ventricular dysfunction and an ejection fraction <25% undergoing coronary artery bypass grafting with CPB were admitted 24 h before surgery and were randomly assigned to receive levosimendan (loading dose 10 μg/kg followed by a 23 h continuous infusion of 0.

[The calcium sensitizer levosimendan gives superior results to dobutamine in postoperative low cardiac output syndrome].

Introduction And Objectives: The use of levosimendan to treat postoperative low cardiac output syndrome (LCOS) has been studied in only small patient series and in randomized trials focusing on hemodynamic variables. The objective of the present study was to assess the effectiveness of levosimendan, compared with dobutamine, as a treatment for postoperative LCOS.

Methods: Patients with LCOS were randomly assigned to receive either levosimendan (loading dose, 10 microg/kg, followed by 0.

Methylene blue reduces mortality and morbidity in vasoplegic patients after cardiac surgery.

Background: The discovery of nitric oxide as mediator in cardiac postoperative vasoplegia encourages the use of inhibitory drugs such as methylene blue. This drug has been used with favorable results in isolated cases. The purpose of this article is to analyze the incidence of the postoperative vasoplegic syndrome, to consider its prognosis, and to evaluate the effect of intravenous methylene blue on mortality.