Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Сенситизаторы кальция в лечении послеоперационного синдрома низкого сердечного выброса в кардиохирургии

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Link: Clinical Physiology of Blood Circulaiton. 2012; (): -

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Abstract

Levosimendan capacity to increase myocardial contractility and reduce afterload with constant concentration of intracellular calcium makes it possible to consider it as one of the most perspective substances for the treatment of low cardiac output syndrome (LCOS) with high systemic or pulmonary vascular resistance. Clinical studies results of patients with LCOS after cardiosurgical interventions confirm that levosimendan improves myocardial contractility function, allows to stabilize hemodynamics, reduces perioperative mortality and requirement for inotropic support and cardiopulmonary bypass including the cases of refractoriness to the standard cardiotonic therapy. Favorable results obtained in the studies of newborns and infants confirm that levosimendan can be used in pediatric cardiosurgery as an alternative to phosphodiesterase III inhibitors in the treatment of LCOS in patients with the left ventricle myocardial insufficiency, high pulmonary hypertension, functionally single ventricle as well as basic substance for cardiopulmonary bypass and with its termination. However many aspects of levosimendan application in this category of patients are studied insufficiently: indications to start levosimendan therapy are not articulated, hemodynamic effects and influ- ence on the outcomes of the newborns and infants with LCOS and safe left ventricle systolic function are studied insufficiently completely. Therefore presently the studies focused on certain sites of levosimendan in the treatment of LCOS in newborns and infants after cardiopulmonary bypass surgery are undoubtedly topical

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