Preconditioning with levosimendan reduces postoperative low cardiac output in moderate-severe systolic dysfunction patients who will undergo elective coronary artery bypass graft surgery: a cost-effective strategy

Autor: Juan José Jiménez-Rivera, Andrea Álvarez-Castillo, Jorge Ferrer-Rodríguez, José Luis Iribarren-Sarrías, Martín Jesús García-González, Pablo Jorge-Pérez, Juan Lacalzada-Almeida, Rosalía Pérez-Hernández, Javier Montoto-López, Rafael Martínez-Sanz
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Journal of Cardiothoracic Surgery, Vol 15, Iss 1, Pp 1-11 (2020)
Druh dokumentu: article
ISSN: 1749-8090
DOI: 10.1186/s13019-020-01140-z
Popis: Abstract Background Patients with moderate-severe systolic dysfunction undergoing coronary artery bypass graft have a higher incidence of postoperative low cardiac output. Preconditioning with levosimendan may be a useful strategy to prevent this complication. In this context, design cost-effective strategies like preconditioning with levosimendan may become necessary. Methods In a sequential assignment of patients with Left Ventricle Ejection Fraction less than 40%, two strategies were compared in terms of cost-effectiveness: standard care (n = 41) versus preconditioning with Levosimendan (n = 13). The adverse effects studied included: postoperative new-onset atrial fibrillation, low cardiac output, renal failure and prolonged mechanical ventilation. The costs were evaluated using deterministic and probabilistic sensitivity analysis, and Monte Carlo simulations were performed. Results Preconditioning with levosimendan in moderate to severe systolic dysfunction (Left Ventricle Ejection Fraction
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