Evidence map›Paper›PMID 15812624›Full record

Trial reportIntensive care medicine2005

Effects of levosimendan on systemic and regional hemodynamics in septic myocardial depression.

Andrea Morelli, Stefano De Castro, Jean-Louis Teboul, Mervyn Singer, Monica Rocco, Giorgio Conti, Leonardo De Luca, Emanuele Di Angelantonio, Alessandra Orecchioni, Natesa G Pandian and 1 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Intensive care medicine, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 88 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
88citing papers in PubMed, 12 pooled it
14.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

88 citing papers in PubMed, 12 syntheses or guidelines pooled it, 301 citations in OpenAlex.

  1. Pooled it
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  7. [S3 Guideline Sepsis-prevention, diagnosis, therapy, and aftercare : Long version].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2020
    Guideline
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  16. Levosimendan Versus Dobutamine in Myocardial Injury Patients with Septic Shock: A Randomized Controlled Trial.Medical science monitor : international medical journal of experimental and clinical research · 2016
    Trial
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  20. Association Between Myocardial Dysfunction and Septic Shock.International journal of molecular sciences · 2026
    Review

28 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 4 countries.

Andrea MorelliDepartment of Anesthesiology and Intensive Care, University of Rome La Sapienza, Rome, Italy. andrea.morelli@uniroma1.it
Stefano De Castro
Jean-Louis Teboul
Mervyn Singer
Monica Rocco
Giorgio Conti
Leonardo De Luca
Emanuele Di Angelantonio
Alessandra Orecchioni
Natesa G Pandian
Paolo Pietropaoli
Sapienza University of Rome · ITBury College · GBTufts Medical Center · USUniversità Cattolica del Sacro Cuore · ITUniversité Paris-Saclay · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveCalcium desensitization plays an important part in the pathophysiology of septic myocardial depression. We postulated that levosimendan, a new calcium sensitizer, would be beneficial in sepsis-induced cardiac dysfunction. DESIGN AND

settingProspective, randomized, controlled study in two university hospital intensive care units. PATIENTS AND

participantsTwenty-eight patients with persisting left ventricular dysfunction related to septic shock after 48 h of conventional treatment including dobutamine (5 microg/kg per minute).

interventionsAfter 48 h of conventional treatment patients were randomized to receive a 24-h infusion of either levosimendan (0.2 microg/kg per minute, n=15) or dobutamine (5 microg/kg per minute, n=13). MEASUREMENTS AND

resultsData from right heart catheterization, echocardiography, gastric tonometry, laser-Doppler flowmetry, and lactate concentrations and creatinine clearance were obtained before and after the 24-h drug infusion. Dobutamine did not change systemic or regional hemodynamic variables. By contrast, at the same mean arterial pressure levosimendan decreased pulmonary artery occlusion pressure and increased cardiac index. Levosimendan decreased left ventricular end-diastolic volume and increased left ventricular ejection fraction. Levosimendan increased gastric mucosal flow, creatinine clearance, and urinary output while it decreased lactate concentrations.

conclusionsThese findings show that levosimendan improves systemic hemodynamics and regional perfusion in patients with septic cardiac dysfunction under conditions where administration of 5 microg/kg dobutamine per minute is no longer efficacious. Accordingly, our results suggest that levosimendan can be an alternative to the strategy of increasing the dose of dobutamine under such conditions.

Indexed as

Cardiac Output, LowCardiotonic AgentsFemaleGastric MucosaHemodynamicsHumansHydrazonesMaleMiddle AgedPyridazinesShock, SepticSimendanStatistics, NonparametricCardiotonic AgentsHydrazonesPyridazinesSimendan

Identifiers

PMID15812624
OpenAlexW1992536611

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.