| ObjectiveThe aim of this study was to investigate the clinical efficacy of levosimendan in patients with difficult weaning from mechanical ventilation,and evaluate the safety and efficacy of levosimendan.MethodsAfter reviewed the data of patients admitted to the Intensive Care Unit of Shenzhen Second People’s Hospital from June 2017 to October 2018.According to the inclusion criteria of this study,30 patients with difficult-to-wean and left ventricular ejection fraction(LVEF)<70%who were recruited as case group.And we recruited 31 patients according to the patient’s gender,age,acute physiology and chronic health II score(APACHE Ⅱ),risk of death(R value)to match the difficult-to-wean and LVEF<70%patients as a control group.The patients were divided into case group(n=30)and control group(n=31)according to levosimendan was given or not.All the patients were given routine symptomatic and supportive treatment,the case group was treated with extra levosimendan treatment on the basis of the control group,no contraindications to levosimendan were used in either group.Next,we compared the baseline between the two groups before treatment,such as age,sex,APACHE II score,N-terminal B-type natriuretic peptide(NT-proBNP),Arterial blood oxygenation index(OI),Hemoglobin(HGB),Hematocrit(HCT)and Platelet(PLT).Then,the NT-proBNP level,OI,liver and kidney function indexes were compared between the two groups on the 3rd day and 7th day after treatment.Finally,the wean success rate of mechanical ventilation,the total time of mechanical ventilation,the length of stay in ICU and the mortality in ICU were compared.Results1、There was no significant difference in APACHE II score,death risk R value,NT-ProBNP,PLT and HGB between the two groups before treatment(P>0.05).2、The level of NT-ProBNP in the levosimendan group was significantly lower than the level of NT-ProBNP in the control group on the 3rd and 7th day after treatment(P<0.05),and the oxygenation index in the levosimendan group was significantly higher than that in the control group(P<0.05).3、There was no significant difference in Total bilirubin(TBIL),Serum glutamic-pyruvic transaminase(ALT),Aspartate transaminase(AST)and Creatinine(CR)between the levosimendan group and the control group after treatment on the 3rd and 7th day after treatment(P>0.05).4、The duration of mechanical ventilation in the levosimendan group were shorter than those in the control group(P=0.001),and the length of hospitalization of ICU in the levosimendan group were shorter than those in the control group(P=0.020).5、The success rate of weaning in the levosimendan treatment group was significantly higher than that in the control group(P=0.027),The mortality of ICU in the case group was 7 cases(23.33%),which was not significantly different from that of 9 cases(29.03%)in the control group(X2=0.256,P>0.05).ConclusionsLevosimendan can effectively shorten the weaning time of patients with difficult-to-wean and improve the success rate of weaning mechanical ventilation. |
