BibTex RIS Kaynak Göster

Per-operative levosimendan use in high-risk patients undergoing coronary artery bypass surgery

Yıl 2012, Cilt: 65 Sayı: 1, 61 - 66, 01.01.2012

Ulaș Kumbasar , Ali Can Hatemi Mustafa Canikoğlu Aybala Tongut Mete Gürsoy Kadir Çeviker İlhan Özgöl Murat Bașkurt Cem Bostan Kamil Karaoğlu

https://doi.org/10.1501/Tipfak_0000000809

Öz

Anahtar Kelimeler

-

Kaynakça

  • Tasouli A, Papadopoulos K, Kriaras J, Georgiadis M, Geroulanos S. Safety and Efficacy of the novel calcium sensitizer Le- vosimendan after open heart surgery: our experience from a pilot study. Interact Cardiovasc Thorac Surg 2005;4:556.
  • Raja SG, Rayen BS. Levosimendan in cardiac surgery: current best available evidence. Ann Thorac Surg 2006;81:1536
  • Nijhawan N, Nicolosi AC, Montgomery T, Aggarwal A, Pagel PS, Warltier DC. Levosimendan performance after cardiopulmonary bypass: a controlled trial. J Cardiovasc Pharmacol ;34:219-228. cardiac prospective, randomized placebo- Iriz E, Erer D, Unal Y, Zor H, Ozkose Z, Ozdogan levosimendan cardiopulmonary bypass. J Card Surg ;22:153-156. use of in a patient during Michaels AD, McKeown B, Kostal M, et al. Effects of intravenous levosimendan on human coronary vasomotor regulation, left ventricular wall stress, and myocardial oxygen uptake. Circulation 2005; 111: –1509.
  • Kaheinen P, Pollesello P, Levijoki J, Haikala H. Levosimendan increases diastolic coronary flow in isolated guinea-pig heart by hannels. ;37:367-374. potassium Pharmacol J Levijoki J, Pollesello P, Kaheinen P, Haikala H. Improved survival with levosimendan after experimental myocardial infarction in rats. Eur J Pharmacol 2001;419:243
  • Takahashi R, Talukder MA, Endoh M. Effects of OR-1896, an active metabolite of levosimendan, on contractile force and aequorin light transients in intact rabbit ventricular myocardium. J Cardiovasc Pharmacol 2000;36:118-125.
  • Boldt J, Kling D, Zickmann B, Dapper F, Hempelmann G. Haemodynamic effects of the phosphodiesterase inhibitor enoximone in comparison with dobutamine in esmololtreated cardiac surgery patients. Br J Anaesth 1990;64:611–616.
  • Labriola C, Siro-Brigiani M, Carrata F, Santangelo E, Amantea B. Hemodynamic effects of levosimendan in patients with low-output heart failure after cardiac surgery. Int J Clin Pharmacol Ther ;42:204-211. Moiseyev VS, Po˜der P, Andrejevs N, et al. RUSSLAN Study Investigators Safety and efficacy of a novel calcium sensitizer, levosimendan, in patients with left ventricular failure due to an acute myocardial infarction. A randomized, placebo-controlled, (RUSSLAN). Eur Heart J 2002; 23: 1422– study
  • Nashef SA, Roques F, Michel P, Gauducheau E, Lemeshow S, Salamon R. European system for cardiac operative risk evaluation Cardiothorac Surg 1999;16:9-13. Eur J
  • Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H, Gutgesell H, Reichek N, Sahn D, Schnittger I, et al. Recommendations for quantitation of the left ventricle by two- dimensional echocardiography. American Society of Echocardiography Committee on Quantitation Echocardiograms. JASE 1989; 2: 358-367. on of Two-Dimensional Schiller NB. Two-dimensional echocardiographic determination of left ventricular volume, systolic function and mass. Summary and discussion of the 1989 recommendations of the American Society of Echocardiography. Circulation 1991; 84: 287.
  • Bauk L, Lopez OF, Miranda GS, Abdala GG, Mora EL, de la Reguera GF. Usefulness of levosimendan in patients with surgery. Arch Cardiol Mex 2004;74:295– before
  • Tritapepe L, De Santis V, Vitale D, et al: Preconditioning effects of levosimendan in coronary artery bypass grafting—A pilot study. Br J Anaesth 2006.96:694-700,
  • Tasouli A, et al., Efficacy and safety of perioperative infusion of levosimendan in patients function undergoing open-heart surgery: importance of early use, Eur J Cardio- thorac Surg 2007;32(4):629-633 cardiac
  • Aksun M, Karahan N, Adanır T, Aran G, Yetkin U, Ozturk T, Şencan A, Ozgurbuz U, Gurbuz A. Timing of levosimendan in cardiac surgery. Anadolu Kardiyol Derg ; 9: 223-230. Kivikko M, Antila S, Eha J, Lehtonen L, Pentikainen PJ. Pharmacodynamics and safety of a new calcium sensitizer, levosimendan and its metabolites during an extended infusion in patients with severe heart failure. J Clin Pharmacol 2002;42: 43
  • Kivikko M, Lehtonen L, Colucci W. haemodynamic levosimendan. intravenous ;107:81-86. effects Circulation Raja SG, Rayen BS. Levosimendan in cardiac surgery: current best available evidence. Ann Thorac Surg 2006;81:1536
  • Du Toit EF, Muller CA, McCarthy J, Opie LH. Levosimendan: effects of a calcium sensitizer on function and arrhythmias and cyclic ischemia/reperfusion in the Langendorff- perfused guinea pig heart. J Pharmacol Exp Ther 1999; 290: 505-514. during
  • De Lemos JA, McGuire DK, Drazner MH. cardiovascular ;362:316-322 peptide in disease. Lancet Kyrzopoulos S, Adamopoulos S, Parissis JT, Rassias J, Kostakis G, Iliodromitis E, Degiannis Levosimendan reduces plasma B-type natriuretic peptide and interleukin 6, and improves central hemodynamics in severe heart failure patients. International Journal of Cardiology 2005;99(3):409-413. DTh.
  • Levin RL, Degrange MA, Porcile R, Salvagio F, Blanco N, Botbol LA. The calcium sensitizer levosimendan gives superior postoperative syndrome. Rev Esp Cardiol. 2008;61:471- in low output
  • De Hert SG, Lorsomradee S, Cromheecke S, Van der Linden PJ. The effects of levosimendan in cardiac surgery patients with poor left ventricular function. Anesth Analg 2007; 104: 766-773.
  • Siirilä-Waris K, Suojaranta-Ylinen R, Harjola V-P. Levosimendan in Cardiac Surgery. Journal of Cardiothoracic and Vascular Anesthesia, 2005;19(3):345-349
  • Akgul A, Mavioglu L, Katircioglu SF, Pac M, Cobanoglu A. Levosimendan for weaning from cardiopulmonary bypass after coronary artery bypass grafting. Heart Lung Circ 2006;15:320-324.

Yüksek Riskle Koroner Arter Cerrahisi Uygulanan Hastalarda Per-Operatif Levosimendan Kullanımı

Yıl 2012, Cilt: 65 Sayı: 1, 61 - 66, 01.01.2012

Ulaș Kumbasar , Ali Can Hatemi Mustafa Canikoğlu Aybala Tongut Mete Gürsoy Kadir Çeviker İlhan Özgöl Murat Bașkurt Cem Bostan Kamil Karaoğlu

https://doi.org/10.1501/Tipfak_0000000809

Öz

Amaç: Kardiyopulmoner bypass (KPB) desteğinin sonlandırılması sırasında miyokardın desteklenmesi için konvansiyonel inotropik ajanlar birçok çalıșmada incelendiği halde yeni ve kalsiyum duyarlılığını arttırarak etki gösteren levosimendan hakkında çalıșmalar sınırlıdır. Bu çalıșmada, koroner arter bypass cerrahisi (KABC) uygulanan ve KPB’den çıkıșta zorlanan hastalarda peroperatif dönemde yükleme dozu yapılmadan bașlanan levosimendanın etkinliği araștırıldı. Materyal ve Method: KABC uygulanan ve yüksek Euroscore’a (>6) sahip 42 hasta çalıșmaya alındı. Hastalara yükleme dozu olmadan, per-operatif dönemde 24 saat boyunca 0.1 mcg/kg/dk hızında intravenöz yolla levosimendan uygulandı. İlaveten tüm hastalara dopamin (5-15 mcg/kg/dk), 39 hastaya adrenalin (0.03-0.2 mcg/kg/dk) ve 9 hastaya da dobutamin (6-20 mcg/kg/dk) infüzyonu uygulandı. KPB’den ayrılamayan 4 hastaya intraaortik balon pompası (İABP) uygulandı. Pre ve postoperatif demografik özellikler, ekokardiyografik ve hemodinamik parametreler ve operatif veriler analiz edildi. Sonuçlar: Ortalama hasta yașı 61.36±9.1 (min:39, maks:77) idi. Ortalama ekstübasyon zamanı 18.34±6.2 saat (min:9, maks:34), ortalama yoğun bakımda kalıș süresi 5.45±2.3 gün (min:1, maks:15) olarak hesaplandı. Pre-operatif ölçümlerle karșılaștırıldığında, levosimendan kullanımını takiben post-operatif dönemde hastalarda istatistiksel olarak anlamlı olacak șekilde sol ventrikül ejeksiyon fraksiyonunda (LVEF) artma, sol atriyum (LA), sol ventrikül (LV) ve sağ ventrikül (RV) diyastol sonu çaplarında küçülme saptandı. Pro-BNP seviyesindeki post-operatif 3. gün görülen artıș da anlamlı bulundu. Ancak, postoperatif 6. aydaki pro-BNP seviyeleri pre-operatif seviyelerden farklı bulunmadı. Kalp hızı ile sistolik ve diyasyolik kan basınçları perfüzyonun 23. saatinde ve perfüzyon kesildikten 1 saat sonra kaydedildi. Kalp hızı sabit kaldığı halde kan basınçlarında anlamlı artıș meydana geldi. Sonuç: Kardiyopulmoner bypass uygulanarak yapılan koroner arter cerrahisinde, özellikle düșük kardiyak debili hastalarda levosimendan konvansiyonel inotroplarla birlikte kullanıldığında etkili bir ilaç olarak görülmektedir.

Anahtar Kelimeler

Koroner arter bypass cerrahisi Düșük kardiyak debi Kardiprotektif ilaçlar Euroscore

Kaynakça

  • Tasouli A, Papadopoulos K, Kriaras J, Georgiadis M, Geroulanos S. Safety and Efficacy of the novel calcium sensitizer Le- vosimendan after open heart surgery: our experience from a pilot study. Interact Cardiovasc Thorac Surg 2005;4:556.
  • Raja SG, Rayen BS. Levosimendan in cardiac surgery: current best available evidence. Ann Thorac Surg 2006;81:1536
  • Nijhawan N, Nicolosi AC, Montgomery T, Aggarwal A, Pagel PS, Warltier DC. Levosimendan performance after cardiopulmonary bypass: a controlled trial. J Cardiovasc Pharmacol ;34:219-228. cardiac prospective, randomized placebo- Iriz E, Erer D, Unal Y, Zor H, Ozkose Z, Ozdogan levosimendan cardiopulmonary bypass. J Card Surg ;22:153-156. use of in a patient during Michaels AD, McKeown B, Kostal M, et al. Effects of intravenous levosimendan on human coronary vasomotor regulation, left ventricular wall stress, and myocardial oxygen uptake. Circulation 2005; 111: –1509.
  • Kaheinen P, Pollesello P, Levijoki J, Haikala H. Levosimendan increases diastolic coronary flow in isolated guinea-pig heart by hannels. ;37:367-374. potassium Pharmacol J Levijoki J, Pollesello P, Kaheinen P, Haikala H. Improved survival with levosimendan after experimental myocardial infarction in rats. Eur J Pharmacol 2001;419:243
  • Takahashi R, Talukder MA, Endoh M. Effects of OR-1896, an active metabolite of levosimendan, on contractile force and aequorin light transients in intact rabbit ventricular myocardium. J Cardiovasc Pharmacol 2000;36:118-125.
  • Boldt J, Kling D, Zickmann B, Dapper F, Hempelmann G. Haemodynamic effects of the phosphodiesterase inhibitor enoximone in comparison with dobutamine in esmololtreated cardiac surgery patients. Br J Anaesth 1990;64:611–616.
  • Labriola C, Siro-Brigiani M, Carrata F, Santangelo E, Amantea B. Hemodynamic effects of levosimendan in patients with low-output heart failure after cardiac surgery. Int J Clin Pharmacol Ther ;42:204-211. Moiseyev VS, Po˜der P, Andrejevs N, et al. RUSSLAN Study Investigators Safety and efficacy of a novel calcium sensitizer, levosimendan, in patients with left ventricular failure due to an acute myocardial infarction. A randomized, placebo-controlled, (RUSSLAN). Eur Heart J 2002; 23: 1422– study
  • Nashef SA, Roques F, Michel P, Gauducheau E, Lemeshow S, Salamon R. European system for cardiac operative risk evaluation Cardiothorac Surg 1999;16:9-13. Eur J
  • Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H, Gutgesell H, Reichek N, Sahn D, Schnittger I, et al. Recommendations for quantitation of the left ventricle by two- dimensional echocardiography. American Society of Echocardiography Committee on Quantitation Echocardiograms. JASE 1989; 2: 358-367. on of Two-Dimensional Schiller NB. Two-dimensional echocardiographic determination of left ventricular volume, systolic function and mass. Summary and discussion of the 1989 recommendations of the American Society of Echocardiography. Circulation 1991; 84: 287.
  • Bauk L, Lopez OF, Miranda GS, Abdala GG, Mora EL, de la Reguera GF. Usefulness of levosimendan in patients with surgery. Arch Cardiol Mex 2004;74:295– before
  • Tritapepe L, De Santis V, Vitale D, et al: Preconditioning effects of levosimendan in coronary artery bypass grafting—A pilot study. Br J Anaesth 2006.96:694-700,
  • Tasouli A, et al., Efficacy and safety of perioperative infusion of levosimendan in patients function undergoing open-heart surgery: importance of early use, Eur J Cardio- thorac Surg 2007;32(4):629-633 cardiac
  • Aksun M, Karahan N, Adanır T, Aran G, Yetkin U, Ozturk T, Şencan A, Ozgurbuz U, Gurbuz A. Timing of levosimendan in cardiac surgery. Anadolu Kardiyol Derg ; 9: 223-230. Kivikko M, Antila S, Eha J, Lehtonen L, Pentikainen PJ. Pharmacodynamics and safety of a new calcium sensitizer, levosimendan and its metabolites during an extended infusion in patients with severe heart failure. J Clin Pharmacol 2002;42: 43
  • Kivikko M, Lehtonen L, Colucci W. haemodynamic levosimendan. intravenous ;107:81-86. effects Circulation Raja SG, Rayen BS. Levosimendan in cardiac surgery: current best available evidence. Ann Thorac Surg 2006;81:1536
  • Du Toit EF, Muller CA, McCarthy J, Opie LH. Levosimendan: effects of a calcium sensitizer on function and arrhythmias and cyclic ischemia/reperfusion in the Langendorff- perfused guinea pig heart. J Pharmacol Exp Ther 1999; 290: 505-514. during
  • De Lemos JA, McGuire DK, Drazner MH. cardiovascular ;362:316-322 peptide in disease. Lancet Kyrzopoulos S, Adamopoulos S, Parissis JT, Rassias J, Kostakis G, Iliodromitis E, Degiannis Levosimendan reduces plasma B-type natriuretic peptide and interleukin 6, and improves central hemodynamics in severe heart failure patients. International Journal of Cardiology 2005;99(3):409-413. DTh.
  • Levin RL, Degrange MA, Porcile R, Salvagio F, Blanco N, Botbol LA. The calcium sensitizer levosimendan gives superior postoperative syndrome. Rev Esp Cardiol. 2008;61:471- in low output
  • De Hert SG, Lorsomradee S, Cromheecke S, Van der Linden PJ. The effects of levosimendan in cardiac surgery patients with poor left ventricular function. Anesth Analg 2007; 104: 766-773.
  • Siirilä-Waris K, Suojaranta-Ylinen R, Harjola V-P. Levosimendan in Cardiac Surgery. Journal of Cardiothoracic and Vascular Anesthesia, 2005;19(3):345-349
  • Akgul A, Mavioglu L, Katircioglu SF, Pac M, Cobanoglu A. Levosimendan for weaning from cardiopulmonary bypass after coronary artery bypass grafting. Heart Lung Circ 2006;15:320-324.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Ulaș Kumbasar

Ali Can Hatemi Bu kişi benim

Mustafa Canikoğlu Bu kişi benim

Aybala Tongut Bu kişi benim

Mete Gürsoy Bu kişi benim

Kadir Çeviker Bu kişi benim

İlhan Özgöl Bu kişi benim

Murat Bașkurt Bu kişi benim

Cem Bostan Bu kişi benim

Kamil Karaoğlu Bu kişi benim

Yayımlanma Tarihi 1 Ocak 2012
Yayımlandığı Sayı Yıl 2012 Cilt: 65 Sayı: 1

Kaynak Göster

APA Kumbasar, U., Hatemi, A. C., Canikoğlu, M., Tongut, A., vd. (2012). Yüksek Riskle Koroner Arter Cerrahisi Uygulanan Hastalarda Per-Operatif Levosimendan Kullanımı. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 65(1), 61-66. https://doi.org/10.1501/Tipfak_0000000809
AMA Kumbasar U, Hatemi AC, Canikoğlu M, Tongut A, Gürsoy M, Çeviker K, Özgöl İ, Bașkurt M, Bostan C, Karaoğlu K. Yüksek Riskle Koroner Arter Cerrahisi Uygulanan Hastalarda Per-Operatif Levosimendan Kullanımı. Ankara Üniversitesi Tıp Fakültesi Mecmuası. Ocak 2012;65(1):61-66. doi:10.1501/Tipfak_0000000809
Chicago Kumbasar, Ulaș, Ali Can Hatemi, Mustafa Canikoğlu, Aybala Tongut, Mete Gürsoy, Kadir Çeviker, İlhan Özgöl, Murat Bașkurt, Cem Bostan, ve Kamil Karaoğlu. “Yüksek Riskle Koroner Arter Cerrahisi Uygulanan Hastalarda Per-Operatif Levosimendan Kullanımı”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 65, sy. 1 (Ocak 2012): 61-66. https://doi.org/10.1501/Tipfak_0000000809.
EndNote Kumbasar U, Hatemi AC, Canikoğlu M, Tongut A, Gürsoy M, Çeviker K, Özgöl İ, Bașkurt M, Bostan C, Karaoğlu K (01 Ocak 2012) Yüksek Riskle Koroner Arter Cerrahisi Uygulanan Hastalarda Per-Operatif Levosimendan Kullanımı. Ankara Üniversitesi Tıp Fakültesi Mecmuası 65 1 61–66.
IEEE U. Kumbasar, “Yüksek Riskle Koroner Arter Cerrahisi Uygulanan Hastalarda Per-Operatif Levosimendan Kullanımı”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, c. 65, sy. 1, ss. 61–66, 2012, doi: 10.1501/Tipfak_0000000809.
ISNAD Kumbasar, Ulaș vd. “Yüksek Riskle Koroner Arter Cerrahisi Uygulanan Hastalarda Per-Operatif Levosimendan Kullanımı”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 65/1 (Ocak 2012), 61-66. https://doi.org/10.1501/Tipfak_0000000809.
JAMA Kumbasar U, Hatemi AC, Canikoğlu M, Tongut A, Gürsoy M, Çeviker K, Özgöl İ, Bașkurt M, Bostan C, Karaoğlu K. Yüksek Riskle Koroner Arter Cerrahisi Uygulanan Hastalarda Per-Operatif Levosimendan Kullanımı. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2012;65:61–66.
MLA Kumbasar, Ulaș vd. “Yüksek Riskle Koroner Arter Cerrahisi Uygulanan Hastalarda Per-Operatif Levosimendan Kullanımı”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, c. 65, sy. 1, 2012, ss. 61-66, doi:10.1501/Tipfak_0000000809.
Vancouver Kumbasar U, Hatemi AC, Canikoğlu M, Tongut A, Gürsoy M, Çeviker K, Özgöl İ, Bașkurt M, Bostan C, Karaoğlu K. Yüksek Riskle Koroner Arter Cerrahisi Uygulanan Hastalarda Per-Operatif Levosimendan Kullanımı. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2012;65(1):61-6.