CLC number: R541.6
On-line Access: 2024-08-27
Received: 2023-10-17
Revision Accepted: 2024-05-08
Crosschecked: 2013-04-12
Cited: 13
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Xuan Huang, Shu Lei, Mei-fei Zhu, Rong-lin Jiang, Li-quan Huang, Guo-lian Xia, Yi-hui Zhi. Levosimendan versus dobutamine in critically ill patients: a meta-analysis of randomized controlled trials[J]. Journal of Zhejiang University Science B, 2013, 14(5): 400-415.
@article{title="Levosimendan versus dobutamine in critically ill patients: a meta-analysis of randomized controlled trials",
author="Xuan Huang, Shu Lei, Mei-fei Zhu, Rong-lin Jiang, Li-quan Huang, Guo-lian Xia, Yi-hui Zhi",
journal="Journal of Zhejiang University Science B",
volume="14",
number="5",
pages="400-415",
year="2013",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1200290"
}
%0 Journal Article
%T Levosimendan versus dobutamine in critically ill patients: a meta-analysis of randomized controlled trials
%A Xuan Huang
%A Shu Lei
%A Mei-fei Zhu
%A Rong-lin Jiang
%A Li-quan Huang
%A Guo-lian Xia
%A Yi-hui Zhi
%J Journal of Zhejiang University SCIENCE B
%V 14
%N 5
%P 400-415
%@ 1673-1581
%D 2013
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1200290
TY - JOUR
T1 - Levosimendan versus dobutamine in critically ill patients: a meta-analysis of randomized controlled trials
A1 - Xuan Huang
A1 - Shu Lei
A1 - Mei-fei Zhu
A1 - Rong-lin Jiang
A1 - Li-quan Huang
A1 - Guo-lian Xia
A1 - Yi-hui Zhi
J0 - Journal of Zhejiang University Science B
VL - 14
IS - 5
SP - 400
EP - 415
%@ 1673-1581
Y1 - 2013
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1200290
Abstract: Objective: To evaluate the clinical efficacy of levosimendan versus dobutamine in critically ill patients requiring inotropic support. Methods: Clinical trials were searched in PubMed, EMBASE, and the Cochrane Central Registry of Clinical Trials, as well as Web of Science. Studies were included if they compared levosimendan with dobutamine in critically ill patients requiring inotropic support, and provided at least one outcome of interest. Outcomes of interest included mortality, incidence of hypotension, supraventricular arrhythmias, and ventricular arrhythmias. Results: Data from a total of 3052 patients from 22 randomized controlled trials (RCTs) were included in the analysis. Overall analysis showed that the use of levosimendan was associated with a significant reduction in mortality (269 of 1373 [19.6%] in the levosimendan group, versus 328 of 1278 [25.7%] in the dobutamine group, risk ratio (RR)=0.81, 95% confidence interval (CI) 0.70–0.92, P for effect=0.002). Subgroup analysis indicated that the benefit from levosimendan could be found in the subpopulations of cardiac surgery, ischemic heart failure, and concomitant β-blocker therapy in comparison with dobutamine. There was no significant difference in the incidence of hypotension, supraventricular arrhythmias, or ventricular arrhythmias between the two drugs. Conclusions: In contrast with dobutamine, levosimendan is associated with a significant improvement in mortality in critically ill patients requiring inotropic support. Patients having cardiac surgery, with ischemic heart failure, and receiving concomitant β-blocker therapy may benefit from levosimendan. More RCTs are required to address the questions about no positive outcomes in the subpopulation in a cardiology setting, and to confirm the advantages in long-term prognosis.
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