Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2014.07.009
Brazilian Journal of Anesthesiology
Clinical Information

Levosimendan as a treatment for acute renal failure associated with cardiogenic shock after hip fracture

Levosimendana como tratamento para insuficiência renal aguda associada a choque cardiogênico após fratura de quadril

Fabiola Quinteros Hinojosa; Margarita Revelo; Alexander Salazar; Genaro Maggi; Renato Schiraldi; Nicolas Brogly; Fernando Gilsanz

Downloads: 0
Views: 703

Abstract

Abstract Inotropic drugs are part of the treatment of heart failure; however, inotropic treatment has been largely debated due to the increased incidence of adverse effects and increased mortality. Recently levosimendan, an inotropic positive agent, has been proved to be effective in acute heart failure, reducing the mortality and improving cardiac and renal performance. We report the case of a 75-year-old woman with history of heart and renal failure and hip fracture. Levosimendan was used in preoperative preparation as an adjuvant therapy, to improve cardiac and renal function and to allow surgery.

Keywords

Levosimendan, Cardiogenic shock, Renal failure, Hip fracture, Perioperative care

Resumo

Resumo Fármacos inotrópicos fazem parte do tratamento de insuficiência cardíaca; no entanto, o tratamento com inotrópicos tem sido amplamente debatido devido ao aumento da incidência de efeitos adversos e da mortalidade. Recentemente, levosimendana, um agente inotrópico positivo, provou ser eficaz na insuficiência cardíaca aguda, reduz a mortalidade e melhora o desempenho cardíaco e renal. Relatamos o caso de uma paciente de 75 anos, com história de insuficiência cardíaca e renal e fratura de quadril. Levosimendana foi usada na preparação do pré-operatório como terapia adjuvante para melhorar a função cardíaca e renal e permitir a cirurgia.

Palavras-chave

Levosimendana, Choque cardiogênico, Insuficiência renal, Fratura de quadril, Cuidados perioperatórios

References

Toller WG, Metzler H. Acute perioperative heart failure. Curr Opin Anaesthesiol. 2005;18:129-35.

Falk S. Anesthetic considerations for the patient undergoing therapy for advanced heart failure. Curr Opin Anaesthesiol. 2011;24:314-9.

Lilleberg J, Nieminem S, Akkila J. Effects of a new calcium sensitizer, levosimendan, on hemodynamics, coronary blood flow an myocardial substrate utilization early after coronary artery bypass grafting. Eur J Heart Fail. 1998;19:660-8.

Follath F. Newer treatments for decompensated heart failure: focus on levosimendan. Drug Des Dev Ther. 2009;3:73-8.

Tavares M, Rezlan E, Vostroknoutova I. New pharmacologic therapies for acute heart failure. Crit Care Med. 2008;36:S112-20.

Yilmaz MB, Yalta K, Yontar C. Levosimendan improves renal function in patients with acute decompensated heart failure: comparison with dobutamine. Cardiovasc Drugs Ther. 2007;21:431-5.

Ponschab M, Hochmair N, Ghazwinian N. Levosimendan infusion improves haemodynamics in elderly heart failure patients undergoing urgent hip fracture repair. Eur J Anaesthesiol. 2008;25:627-33.

Hillege HL, Nitsch D, Pfeffer MA. Renal function as a predictor of outcome in a broad spectrum of patients with heart failure. Circulation. 2006;113:671-8.

Smith GL, Vaccarino V, Kosiborod M. Worsening renal function: what is a clinically meaningful change in creatinine during hospitalization with heart failure?. J Card Fail. 2003;9:13-25.

Stilianos K, Athina K, Panagiotis D. Prophylactic preoperative levosimendan administration in heart failure patients undergoing elective non-cardiac surgery: a preliminary report. Hellenic J Cardiol. 2009;50:185-92.

Tamargo J, López-Sendón J. Bases y evidencias clínicas de los efectos de los nuevos tratamientos farmacológicos en la insuficiencia cardiaca. Rev Esp Cardiol. 2004;57:447-64.

Landoni G, Mizzi A, Biondi-Zoccai G. Levosimendan reduces mortality in critically ill patients. A meta-analysis of randomized controlled studies. Minerva Anestesiol. 2010;76:276-86.

Adamopoulos S, Parissis JT, Iliodromitis EK. Effects of levosimendan versus dobutamine on inflammatory and apoptotic pathways in acutely decompensated chronic heart failure. Am J Cardiol. 2006;98:102-6.

Zorlu A, Yücel H, Yontar O. Effect of levosimendan in patients with severe systolic heart failure and worsening renal function. Arq Bras Cardiol. 2012;98:537-43.

Álvarez J, Bouzada M, Fernandez AL. Comparación de los efectos hemodinámicos del Levosimendan con la dobutamina en pacientes con bajo gasto después de cirugía cardiaca. Rev Esp Cardiol. 2006;59:338-45.

5dcda0230e88253474bf58f2 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections