Levosimendan confers perioperative renoprotection in severe patients undergoing cardiac surgery: A systematic review and meta-analysis
10.7507/1007-4848.201803013
- VernacularTitle:左西孟旦对左心功能不全心脏病患者围术期肾保护作用的系统评价与 Meta 分析
- Author:
ZHOU Chenghui
1
;
GONG Junsong
1
;
LIU Bin
2
Author Information
1. Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, P.R.China
2. Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China
- Publication Type:Journal Article
- Keywords:
Levosimendan;
left ventricular dysfunction;
cardiac surgery;
acute kidney injury;
systematic review and meta-analysis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2019;26(5):470-479
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of levosimendan on acute kidney injury (AKI) in patients with left ventricular dysfunction (preoperative left ventricular ejection fraction≤40.0%) undergoing cardiac surgery. Methods A systematic review and meta-analysis was conducted based on a comprehensive search of the randomized controlled trial (RCT) from PubMed, EMbase and The Cochrane Library (up to Jan 2018). The clinical endpoints included the incidence of AKI and need for renal replacement therapy (RRT), mortality, mechanic ventilation (MV) duration and intensive care unit (ICU) stay. Random-effect model was used for the potential clinical inconsistency. All analyses were performed by RevMan 5.3 and Stata 12.0. Results Thirteen trials with a total of 2 046 patients were selected. Compared with controls, levosimendan significantly reduced the incidence of postoperative AKI (OR=0.44, P=0.000 1, I2=0%), the risk of RRT (OR=0.63, P=0.02, I2=0%) and the mortality (OR=0.49, P<0.000 1, I2=0%). Levosimendan also shortened the postoperative MV duration (WMD=–5.62, P=0.07, I2=93%) and ICU stay (WMD=–1.50, P=0.005, I2=98%). Conclusion The present meta-analysis suggests that perioperative levosimendan for patients with left ventricular ejection fraction≤40.0%undergoing cardiac surgery reduces the incidence of AKI, RRT and death, as well as shortens MV duration and ICU stay.
