Effects of Levosimendan in Acute Kidney Injury After Cardiac Surgery
Acute Kidney Injury
Enrolment: 30 · Results not recorded
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Drug · Calcium sensitiser: binds cardiac troponin C to increase Ca2+ affinity (POSITIVE MODULATOR); also phosphodiesterase-3 inhibition and vascular KATP channel opening causing vasodilation
1 linked trials carry an injury-indication flag. These flags support record-level exploration and sit alongside the stringent aggregate counts described in Methods.
Acute Kidney Injury
Enrolment: 30 · Results not recorded
STEMI · Heart Failure
Enrolment: 500 · Results not recorded
Heart Failure
Enrolment: 70 · Results not recorded
Aortic Valve Stenosis · Heart Failure
Enrolment: 124 · Results not recorded
Aortic Coarctation
Enrolment: 40 · Results not recorded
Acute Heart Failure · NSTEMI
Enrolment: 470 · Results not recorded
Cardiopulmonary Bypass Graft
Enrolment: 81 · Results not recorded
Heart Failure, Congestive
Enrolment: 600 · Results not recorded
Transient Ischemic Attack · Stroke
Enrolment: 32 · Results not recorded
Low Cardiac Output Syndrome
Enrolment: 40 · Results not recorded
Septic Shock
Enrolment: 40 · Results not recorded
Cardiac Surgery
Enrolment: 100 · Results not recorded
3 studies reported at therapy level; 3 evidence entries itemised.
Model: Asphyxial cardiac arrest induced by stopping mechanical ventilation in urethane-anaesthetised, tracheotomised and instrumented rats, with arrest defined as mean arterial pressure below 10 mmHg after about 3 min, followed by cardiopulmonary resuscitation with chest compressions at about 300 per minute to a depth of 1 cm; associated acute lung injury assessed after resuscitation
Return of spontaneous circulation occurred in 10 of 10 rats given epinephrine plus levosimendan, 8 of 10 given epinephrine alone and 2 of 10 given levosimendan alone (p < 0.001), and survival at 60 min was 10, 4 and 2 rats respectively (p = 0.001). Coronary perfusion pressure and mean arterial pres…
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Model: Doxorubicin-induced sub-chronic and chronic cardiotoxicity (cumulative doxorubicin 18 mg/kg)
A single bolus of levosimendan abrogated doxorubicin cardiotoxicity and activated Akt/eNOS and cAMP-PKA/cGMP-PKG/phospholamban signalling, with no protection in phospholamban knockout mice; cardioprotection persisted in the breast cancer-bearing model and was abolished by PKA inhibition in vitro.
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Model: Blunt thoracic trauma with pulmonary contusion
Levosimendan reduced alveolar congestion, haemorrhage and neutrophil infiltration and lowered serum IL-1beta (both doses) and IL-6 and NO (high dose), partially correcting pulmonary damage, although TNF-alpha and pulmonary NF-kappaB activation were not reduced
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