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The effect of levos...
The effect of levosimendan on survival and cardiac performance in an ischemic cardiac arrest model - A blinded randomized placebo -controlled study in swine
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- Rysz, Susanne (author)
- Karolinska Institutet
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- Lundberg, Johan (author)
- Karolinska Institutet
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- Nordberg, Per (author)
- Karolinska Institutet
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- Eriksson, Helen (author)
- Stockholms universitet,Sociologiska institutionen
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- Wieslander, Bjorn (author)
- Karolinska Institutet
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- Lundin, Magnus (author)
- Karolinska Institutet
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- Fyrdahl, Alexander (author)
- Karolinska Institutet
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- Pernow, John (author)
- Karolinska Institutet
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- Ugander, Martin (author)
- Karolinska Institutet
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- Djarv, Therese (author)
- Karolinska Institutet
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- Fagerlund, Malin Jonsson (author)
- Karolinska Institutet
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(creator_code:org_t)
- Elsevier BV, 2020
- 2020
- English.
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In: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 150, s. 113-120
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Background: Survival after out-of-hospital cardiac arrest remains poor. Levosimendan could be a new intervention in this setting. Therefore, we conducted a blinded, placebo controlled randomized study investigating the effects of levosimendan on survival and cardiac performance in an ischemic cardiac arrest model in swine. Methods: Twenty-four anesthetised swines underwent experimentally-induced acute myocardial infarction and ventricular fibrillation. At the start of CPR, a bolus dose of levosimendan (12 μg kg-1) or placebo was given followed by a 24-h infusion (0.2 μg kg-1 min-1) after return of spontaneously circulation. Animals were evaluated by risk of death, post-resuscitation hemodynamics and infarction size by magnetic resonance imaging (MRI) up to 32 h post arrest. Results: Spontaneous circulation was restored in all (12/12) animals in the levosimendan group compared to two thirds (8/12) in the placebo group (P = 0.09). Protocol survival was higher for the levosimendan group (P = 0.02) with an estimated 88% lower risk of death compared to placebo (hazard ratio [95% confidence interval] 0.12 [0.01-0.96], P = 0.046). Cardiac output (CO) recovered 40% faster during the first hour of the intensive care period for the levosimendan group (difference 0.13 [0.01-0.26] L min-1P = 0.04). The placebo group required higher inotropic support during the intensive care period which masked an even bigger recovery in CO in the levosimendan group (58%). The MRI showed no difference in myocardial scar size or in myocardial area at risk. Conclusions: Levosimendan given intra-arrest and during the first 24-h of post-resuscitation care improved survival and cardiac performance in this ischemic cardiac arrest model. Institutional Protocol Number; KERIC 5.2.18-14933.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Rysz, Susanne
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Lundberg, Johan
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Nordberg, Per
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Eriksson, Helen
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Wieslander, Bjor ...
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Lundin, Magnus
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Fyrdahl, Alexand ...
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Pernow, John
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Ugander, Martin
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Djarv, Therese
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Fagerlund, Malin ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Anesthesiology a ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Resuscitation
- By the university
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Stockholm University
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Karolinska Institutet