Beneficial impact of levosimendanin critically ill patients with or at riskfor acute renal failure: a meta-analysisof randomized clinical trials
Heart, Lung and Vessels
; 07(01): 35-46, 2015. ilus
Artigo
em Inglês
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1063255
Biblioteca responsável:
BR79.1
Localização: BR79.1
ABSTRACT
The incidence of Acute Kidney Injury is nowadays high in critically ill patients. Its etiology ismultifactorial and a primary role is played by low cardiac output syndrome. Everything targeted to normalizecardiac output should increase the renal perfusion and abolish the secondary vasoconstriction. Levosimendanis a calcium sensitizer drug with inotropic properties that improves cardiac output and seems to increase renalblood flow. The aim of this meta-analysis was to evaluate the role of levosimendan in critically ill patients withor at risk of Acute Kidney Injury.Methods:
We performed a meta-analysis of randomized controlled trials searching for trials that comparedlevosimendan with any comparator. The endpoints were the number of patients receiving Renal ReplacementTherapy after randomization and the number of patients developing Acute Kidney Injury.Results:
Final analysis included 33 trials and 3,879 patients (2,024 levosimendan and 1,855 control). Theoverall analysis showed that the use of levosimendan was associated with a significant reduction in the riskof Renal Replacement Therapy (17 of 492 [3.5%] in the levosimendan group versus 37 of 427 [8.7%] in thecontrol group, relative risk =0.52 [0.32 to 0.86], p for effect =0.01) and of Acute Kidney Injury (114 of 1,598[7.1%] in the levosimendan group versus 143 of 1,529 [9.4%] in the control arm, relative risk =0.79 [0.63 to0.99], p for effect =0.048).Conclusions:
This meta-analysis suggests that the use of levosimendan is associated with a significant reductionof Renal Replacement Therapy in critically ill patients.
Buscar no Google
Coleções:
Bases de dados nacionais
/
Brasil
Base de dados:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Assunto principal:
Terapia de Substituição Renal
/
Cuidados Críticos
/
Injúria Renal Aguda
Tipo de estudo:
Ensaio clínico controlado
/
Estudo de etiologia
/
Fatores de risco
/
Revisão sistemática
Idioma:
Inglês
Revista:
Heart, Lung and Vessels
Ano de publicação:
2015
Tipo de documento:
Artigo
Instituição/País de afiliação:
A O Regionale San Carlo/IT
/
Instituto Dante Pazzanese de Cardiologia/BR
/
San Raffaele Scientific Institute/IT
/
State Research Institute of Circulation Pathology/RU
/
University Hospital Dubrava/HR
/
University of Milan/IT