The effects of levosimendan on prognosis and circulatory function of sepsis patients: a Meta-analysis
10.3969/j.issn.1008-9691.2018.02.002
- VernacularTitle:左西孟旦对脓毒症患者预后及循环功能影响的Meta分析
- Author:
Honghua ZHANG
1
;
Guoxiu ZHANG
;
Jie LI
;
Xiaolei WEI
;
Dahuan LI
;
Ji YUAN
Author Information
1. 471003 河南洛阳,河南科技大学临床医学院,河南科技大学第一附属医院急诊科
- Keywords:
Sepsis;
Levosimendan;
Mortality;
Time of stay in intensive care unit
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2018;25(2):120-126
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of levosimendan on prognosis and circulation disorders of sepsis patients. Methods With the guidance of these following Chinese or English key words, such as sepsis, severe sepsis, septic shock, simendan, levosimendan, etc., some of Chinese and foreign published literatures on randomized controlled trials (RCTs) concerning the effects of levosimendan on the prognosis and circulatory function of septic patients were searched through China National Knowledge Infrastructure (CNKI) internet, VIP and Wanfang Databases, China Biomedicine Database (CMB), Pubmed in American National library, Holland Medical Abstract Database (Embase), Cochrane Library, etc databases, from the creation of above various databases to May 2017. The quality of the collected RCTs was evaluated by modified Jadad score; Revman 5.3 software was used to carry out Meta analysis; the publication bias was assessed by the funnel plots. Results A total of 18 RCTs, 9 in Chinese and 9 in English, but only half of the literatures were of high quality, and the other 9 of low quality, containing 688 cases in control group and 704 cases in experimental group were ultimately enrolled in this analysis. The Meta analyses showed that there was no statistical significant difference in the mortality between the experimental group and the control group [relative risk (RR) = 0.92, 95% confidence interval (95%CI) = 0.80 - 1.06, P = 0.27]; compared with control group, the time of stay in ICU was shortened [mean difference (MD) = -2.02, 95%CI = -2.90 to -1.13, P < 0.000 01], cardic output index was increased (MD = 0.63, 95%CI = 0.39 - 0.87, P < 0.000 01), and blood lactate level was decreased (MD = -1.37, 95%CI = -1.51 to-1.23, P < 0.000 01) in the experimental group, being significantly improved after levosimendan therapy. The funnel map evaluation showed that there might be a certain bias in the publication of the literature. Conclusion Levosimendan can improve circulatory disorders and reduce the time of stay in ICU for septic patients, but can not reduce their mortality.
