@article{Atalay_Temizturk_Altinsoy_Azboy_Atalay_Colak_Dogan_2016, title={Levosimendan Use Increases Cardiac Performance after Coronary Artery Bypass Grafting in End-Stage Renal Disease Patients}, volume={19}, url={https://journal.hsforum.com/index.php/HSF/article/view/1426}, DOI={10.1532/hsf.1426}, abstractNote={<strong>Background:</strong> The effect of levosimendan on myocardial performance has not been studied in dialysis-dependent end-stage renal disease patients who have undergone coronary artery bypass grafting (CABG) surgery. Our aim was to investigate the effect of levosimendan on postoperative hemodynamic effects in end-stage renal disease patients undergoing CABG operation.<br /><strong>Methods:</strong> We performed 58 elective isolated CABG operations in end-stage renal disease patients. The study group received levosimendan at a slow bolus dose of 3 µg/kg, followed by a 24-hour infusion of 0.03-0.05 µg/kg/kg/min. (study group [SG]: n = 25). The remaining patients received a placebo (control group [CG]: n = 33). The mean left ventricular ejection fraction of both groups was similar (44.6 ± 55.4% versus 42.8 ± 53.9%). Hemodynamic data were collected at the end, at 1 hour after CPB, and thereafter at 6, 12, and 24 hours in the ICU. Preoperatively, at the end of the operation, at 1 hour after CPB, and thereafter at 6, 12, and 24 hours in the ICU, blood samples from the peripheral vein were collected for cardiac troponin-I (c-TnI) and lactate levels. Norepinephrine if needed started during the rewarming period in both groups.<br /><strong>Results:</strong> One patient in SG (4%) and 4 patients (12.1%) in CG died postoperatively (P &lt; .01). Cardiac output and cardiac index values did not change early after weaning from extracorporeal circulation, and they were nearly similar during the next 6 hours in both groups. In SG, cardiac output and cardiac index significantly improved at 6 hours, and were stable at the end of 24 hours (P &lt; .001). Hemodynamic parameters were nearly similar after the operation, and did not change significantly at the end of 24 hours in CG. Hemodynamic improvement caused a significant reduction in systemic and pulmonary artery vascular resistance index in SG (P &lt; .002). Pulmonary capillary wedge pressure decreased significantly in SG (P &lt; .034). Cumulative inotrope dose requirement and intraaortic balloon pump use were significantly lower in SG. In addition, blood lactate and cTnI levels were significanly lower in SG (P &lt; .044).<br /><strong>Conclusion:</strong> No important adverse effect was detected during levosimendan infusion. Because levosimendan at a dose of 0.03-0.05 μg/kg/min increased myocardial performance significantly in the postoperative period, it can be used safely in end-stage renal disease patients undergoing isolated CABG. The requirement of vasopressors were lower in SG.}, number={5}, journal={The Heart Surgery Forum}, author={Atalay, Hakan and Temizturk, Zeki and Altinsoy, Hasan Baki and Azboy, Davut and Atalay, Atakan and Colak, Salih and Dogan, Omer Faruk}, year={2016}, month={Oct.}, pages={E230-E236} }