The Effectiveness of Levosimendan on Veno-Arterial Extracorporeal Membrane Oxygenation Management and Outcome: A Systematic Review and Meta-Analysis

ObjectivesVeno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides a temporary support system for patients with cardiogenic shock refractory to conventional medical therapies. It has been reported that levosimendan may facilitate VA-ECMO weaning and improve survival. The primary objective of this review was examine the effect use on mortality in critically ill VA-ECMO.DesignMEDLINE, EMBASE, CENTRAL were searched. A pair reviewers identified eligible clinical trials. Two extracted data independently assessed risk bias. random-effect model used combine data. outcome success from VA-ECMO.Measurements Main ResultsSeven studies observational design, including total 630 patients, selected final analysis. sample size ranged ten-to-240 mean age between 53 65 years, more than half them underwent cardiac surgeries. durations varied four 11.6 days. Overall, significantly associated successful compared control (odds ratio [OR] 2.89, 95% CI, 1.53-5.46; poverall = 0.001); I2 49%). For survival, six (n 617) included meta-analysis involving 326 group 291 comparator group. Pooled results showed higher survival rate (OR 0.46, 0.30-0.71; 0.0004; 20%).ConclusionsLevosimendan therapy benefit or postcardiotomy needing severe cardiocirculatory compromise. To date, there is limited literature absence evidence randomized trials addressing weaning. This study be considered hypothesis-generating research controlled confirm its findings. Veno-arterial VA-ECMO. MEDLINE, Seven 20%). Levosimendan