SynthesisJournal of Zhejiang University. Science. B2013
Levosimendan versus dobutamine in critically ill patients: a meta-analysis of randomized controlled trials.
Synthesis in Journal of Zhejiang University. Science. B, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 4 of them syntheses that pooled 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.
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.
Who cites it
14 citing papers in PubMed, 4 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- Effect of levosimendan on ventricular remodelling in patients with left ventricular systolic dysfunction: a meta-analysis.ESC heart failure · 2024Pooled it
- Inotropic agents and vasodilator strategies for the treatment of cardiogenic shock or low cardiac output syndrome.The Cochrane database of systematic reviews · 2020Pooled it
- Inotropic agents and vasodilator strategies for the treatment of cardiogenic shock or low cardiac output syndrome.The Cochrane database of systematic reviews · 2018Pooled it
- Effects of levosimendan for low cardiac output syndrome in critically ill patients: systematic review with meta-analysis and trial sequential analysis.Intensive care medicine · 2015Pooled it
- Levosimendan Improves Clinical Outcomes of Refractory Heart Failure in Elderly Chinese Patients.Medical science monitor : international medical journal of experimental and clinical research · 2015Trial
- Comparative safety and efficacy of levosimendan versus dobutamine in acute heart failure: a systematic review, meta-analysis, and meta-regression.Annals of medicine and surgery (2012) · 2026Article
- Managing Arrhythmias in Cardiogenic Shock: Insights Into Milrinone and Dobutamine Therapy.Cureus · 2024Review
- Is there any difference in the therapeutic effects of Levosimendan on advanced HFrEF patients with sinus rhythm or atrial fibrillation?Frontiers in cardiovascular medicine · 2023Article
- Levosimendan Administration May Provide More Benefit for Survival in Patients with Non-Ischemic Cardiomyopathy Experiencing Acute Decompensated Heart Failure.Journal of clinical medicine · 2022Article
- Levosimendan in the modern treatment of patients with acute heart failure of various aetiologies.Archives of medical science : AMS · 2021Article
- Renal and Neurologic Benefit of LevosimendanFrontiers in pharmacology · 2020Article
- Effects of milrinone on serum IL-6, TNF-α, Cys-C and cardiac functions of patients with chronic heart failure.Experimental and therapeutic medicine · 2018Article
- Role of PiCCO monitoring for the integrated management of neurogenic pulmonary edema following traumatic brain injury: A case report and literature review.Experimental and therapeutic medicine · 2016Article
- Levosimendan: current data, clinical use and future development.Heart, lung and vessels · 2013Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the clinical efficacy of levosimendan versus dobutamine in critically ill patients requiring inotropic support.
methodsClinical trials were searched in PubMed, EMBASE, and the Cochrane Central Registry of Clinical Trials, as well as Web of Science. Studies were included if they compared levosimendan with dobutamine in critically ill patients requiring inotropic support, and provided at least one outcome of interest. Outcomes of interest included mortality, incidence of hypotension, supraventricular arrhythmias, and ventricular arrhythmias.
resultsData from a total of 3052 patients from 22 randomized controlled trials (RCTs) were included in the analysis. Overall analysis showed that the use of levosimendan was associated with a significant reduction in mortality (269 of 1373 [19.6%] in the levosimendan group, versus 328 of 1278 [25.7%] in the dobutamine group, risk ratio (RR)=0.81, 95% confidence interval (CI) 0.70-0.92, P for effect=0.002). Subgroup analysis indicated that the benefit from levosimendan could be found in the subpopulations of cardiac surgery, ischemic heart failure, and concomitant β-blocker therapy in comparison with dobutamine. There was no significant difference in the incidence of hypotension, supraventricular arrhythmias, or ventricular arrhythmias between the two drugs.
conclusionsIn contrast with dobutamine, levosimendan is associated with a significant improvement in mortality in critically ill patients requiring inotropic support. Patients having cardiac surgery, with ischemic heart failure, and receiving concomitant β-blocker therapy may benefit from levosimendan. More RCTs are required to address the questions about no positive outcomes in the subpopulation in a cardiology setting, and to confirm the advantages in long-term prognosis.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.