Abstract
Background VA ECMO is commonly used to support patients suffering profound cardiogenic shock. However, the ideal strategy to wean patients of VA ECMO remains unknown. Methods A systematic search including Pubmed, Cochrane Library and EMBASE was performed to evaluate studies comparing Levosimendan vs. other weaning strategies in patients with cardiogenic shock on VA-ECMO. Evaluated end-point was successful discontinuation on VA-ECMO support. Results Four studies met inclusion criteria for a total of 471 patients, . Mean age was 61, 292 (70%) of the patients were male. Hypertension, CAD and Diabetes were present in 282 patients (60%), 216 (46%) and 136 (29%) respectively, with no significant difference in between groups. The majority of patients required ECMO due to acute myocardial infarction or post cardiotomy shock (up to 50%). 262 received Levosimendan and 209 recieved other interventions. Out of the group who received the calcium sensitizer 215 patients (82%) were successfully weaned vs 135 patients (65%) on the control group, OR 1.27 (CI 95% 1.13-1.4) P Conclusions This metanalysis suggests that the use of Levosimendan on patients while on VA ECMO support for cardiogenic shock improves weaning success
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