Effects Of Levosimendan On Patients After Cardiac Surgery

Objective: To study the effection of Levosimendan (LS) for heart surgery patients with cardiac insufficiency through the application of PICCO, and provide clinical basis for heart surgery patients with cardiac insufficiency.Methods: Twenty one patients are chosen in the Tianjin chest hospitalfrom May2013to December2013,including12men and8women whoaged(73.5±9.5). Nine patients with aortic balloon counterpulsation (IABP) support. All subjects were carefully selected non-stop jump coronary bypass grafting (OPCABG) patients, postoperative mechanical ventilation, Prior to treatment ultrasound ejection fraction≤40%, by regular anti-heart failure treatment, eliminate shock. Severe hepatic, renal insufficiency; hypovolemia, surgical bleeding; continuous blood purification patients; serious mechanical obstruction disease; electrolyte imbalance (hyperkalemia, hypokalemia); arrhythmia (including atrioventricular block, heart tachycardia, ventricular fibrillation, etc.) Drug allergies, etc. Selected samples are self-control, applicated Qilu Pharmaceutical production levosimendan and PICCO detector, exclude human interference. Patient medication collect general information (blood pressure, heart rate, respiration, central venous pressure, ultrasound, biochemical parameters, etc.) before. Levosimendan to0.1μg/(kg·min) continuous infusion rate of24hours, Respectively, before treatment, medication3hours,6hours,12hours,24hours,48hours PICCO monitored. Each point detection time to take end-expiratory,15ML ice brine continuous thermodilution cardiac output measured three times and averaged. Patients who use IABP patients, pause counterpulsation work. Meanwhile record patient vital signs parameters, indicators and related laboratory inotropic score.Results:1. Comparison of clinical data:①Research has found difference of potassium in the blood6hours after medication and other electrolytes before treatment,there was no difference in statistics;②Before and after treatment in patients with blood pressure, heart rate, respiration showed no statistical difference;③Biochemical indexes before and after treatment in patients with liver function, renal function, blood glucose, blood routine test, there were no significant differences in myocardial enzyme;④Inotropic scores are not statistically significant.2. Data comparison of PICCO:cardiac index, SVI, and GEF increased obviously after treatment, SVR and SVRI decreased. Significant adverse reaction of blood pressure fluctuation and arrhythmiapatients all did not appear. Study found that the application of levosimendanafter12hours can be slightly reduced inotropic scores, but not statistically significant.3. Following-up:All of the twenty patients survive and discharge from hospital with less of Ventilator time and drug dependence.Conclusion:1. Application PICCO can intuitively accurate hemodynamic changes observed in patients2. Levosimendan may improve hemodynamic parameters and prognosis.3. Levosimendan can low peripheral circulation resistance, pulmonary artery pressure,pulmonary capillary pressure and pulmonary vascular resistance. It also can increase cardiac output and stroke volume and improve improve cardiac function.4. levosimendan may affect serum potassium concentration, no significant effect on the positive inotropic drugs.