Evidence map›Paper›PMID 27705084›Full record

ArticleThe New England journal of medicine2016

Levosimendan for the Prevention of Acute Organ Dysfunction in Sepsis.

Anthony C Gordon, Gavin D Perkins, Mervyn Singer, Daniel F McAuley, Robert M L Orme, Shalini Santhakumaran, Alexina J Mason, Mary Cross, Farah Al-Beidh, Janis Best-Lane and 7 more

Registry-linked trialOpen access · bronzeAbstract read
PubMed Publisher
In one paragraph

Article in The New England journal of medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04020003 (A Clinical Study on Levosimendan Improvement of Prognosis of ARDS Patients by Optimizing Pulmonary Hemodynamics), which is not on this map. Cited by 171 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
171citing papers in PubMed, 14 pooled it
34.6field-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.

NCT04020003 phase3unknown statusnot on this mapstarted 2019, after this paper: background citation

A Clinical Study on Levosimendan Improvement of Prognosis of ARDS Patients by Optimizing Pulmonary Hemodynamics

TypeinterventionalSponsorShenzhen Second People's HospitalRan2019 to 2022Enrolled120ConditionsARDS, HumanArmsLevosimendan
3 · Its place in the literature

Who cites it

171 citing papers in PubMed, 14 syntheses or guidelines pooled it, 360 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025
    Guideline
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. [S3 Guideline Sepsis-prevention, diagnosis, therapy, and aftercare : Long version].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2020
    Guideline
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. Guideline
  15. Trial
  16. Trial
  17. Trial
  18. Trial
  19. Trial
  20. Trial

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

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 4 institutions in 3 countries.

Anthony C GordonFrom the Section of Anaesthetics, Pain Medicine and Intensive Care Medicine, the Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust (A.C.G., F.A.-B., J.B.-L.), Bloomsbury Institute of Intensive Care Medicine, the Division of Medicine, University College London (M.S.), Imperial Clinical Trials Unit Imperial College London (S.S., M.C., F.A.-B., J.B.-L., D.A.), the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (A.J.M.), and the Division of Critical Care, University College London Hospitals (D.B.), London, Warwick Clinical Trials Unit, University of Warwick and Heart of England NHS Foundation Trust, Coventry (G.D.P.), the Centre for Experimental Medicine, Queen's University of Belfast (D.F.M., J.J.M.), and the Regional Intensive Care Unit, the Royal Hospitals (D.F.M., J.J.M.), Belfast, the Department of Critical Care, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham (R.M.L.O.), Intensive Care Unit, Antrim Area Hospital, Antrim (C.L.N.), Intensive Care Unit, Poole Hospital NHS Foundation Trust, Poole (H.R.), and Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds (A.B.) - all in the United Kingdom; and the Department of Medicine, University of California at San Francisco, San Francisco (K.D.L.).
Gavin D PerkinsFrom the Section of Anaesthetics, Pain Medicine and Intensive Care Medicine, the Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust (A.C.G., F.A.-B., J.B.-L.), Bloomsbury Institute of Intensive Care Medicine, the Division of Medicine, University College London (M.S.), Imperial Clinical Trials Unit Imperial College London (S.S., M.C., F.A.-B., J.B.-L., D.A.), the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (A.J.M.), and the Division of Critical Care, University College London Hospitals (D.B.), London, Warwick Clinical Trials Unit, University of Warwick and Heart of England NHS Foundation Trust, Coventry (G.D.P.), the Centre for Experimental Medicine, Queen's University of Belfast (D.F.M., J.J.M.), and the Regional Intensive Care Unit, the Royal Hospitals (D.F.M., J.J.M.), Belfast, the Department of Critical Care, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham (R.M.L.O.), Intensive Care Unit, Antrim Area Hospital, Antrim (C.L.N.), Intensive Care Unit, Poole Hospital NHS Foundation Trust, Poole (H.R.), and Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds (A.B.) - all in the United Kingdom; and the Department of Medicine, University of California at San Francisco, San Francisco (K.D.L.).
Mervyn SingerFrom the Section of Anaesthetics, Pain Medicine and Intensive Care Medicine, the Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust (A.C.G., F.A.-B., J.B.-L.), Bloomsbury Institute of Intensive Care Medicine, the Division of Medicine, University College London (M.S.), Imperial Clinical Trials Unit Imperial College London (S.S., M.C., F.A.-B., J.B.-L., D.A.), the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (A.J.M.), and the Division of Critical Care, University College London Hospitals (D.B.), London, Warwick Clinical Trials Unit, University of Warwick and Heart of England NHS Foundation Trust, Coventry (G.D.P.), the Centre for Experimental Medicine, Queen's University of Belfast (D.F.M., J.J.M.), and the Regional Intensive Care Unit, the Royal Hospitals (D.F.M., J.J.M.), Belfast, the Department of Critical Care, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham (R.M.L.O.), Intensive Care Unit, Antrim Area Hospital, Antrim (C.L.N.), Intensive Care Unit, Poole Hospital NHS Foundation Trust, Poole (H.R.), and Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds (A.B.) - all in the United Kingdom; and the Department of Medicine, University of California at San Francisco, San Francisco (K.D.L.).
Daniel F McAuleyFrom the Section of Anaesthetics, Pain Medicine and Intensive Care Medicine, the Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust (A.C.G., F.A.-B., J.B.-L.), Bloomsbury Institute of Intensive Care Medicine, the Division of Medicine, University College London (M.S.), Imperial Clinical Trials Unit Imperial College London (S.S., M.C., F.A.-B., J.B.-L., D.A.), the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (A.J.M.), and the Division of Critical Care, University College London Hospitals (D.B.), London, Warwick Clinical Trials Unit, University of Warwick and Heart of England NHS Foundation Trust, Coventry (G.D.P.), the Centre for Experimental Medicine, Queen's University of Belfast (D.F.M., J.J.M.), and the Regional Intensive Care Unit, the Royal Hospitals (D.F.M., J.J.M.), Belfast, the Department of Critical Care, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham (R.M.L.O.), Intensive Care Unit, Antrim Area Hospital, Antrim (C.L.N.), Intensive Care Unit, Poole Hospital NHS Foundation Trust, Poole (H.R.), and Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds (A.B.) - all in the United Kingdom; and the Department of Medicine, University of California at San Francisco, San Francisco (K.D.L.).
Robert M L OrmeFrom the Section of Anaesthetics, Pain Medicine and Intensive Care Medicine, the Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust (A.C.G., F.A.-B., J.B.-L.), Bloomsbury Institute of Intensive Care Medicine, the Division of Medicine, University College London (M.S.), Imperial Clinical Trials Unit Imperial College London (S.S., M.C., F.A.-B., J.B.-L., D.A.), the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (A.J.M.), and the Division of Critical Care, University College London Hospitals (D.B.), London, Warwick Clinical Trials Unit, University of Warwick and Heart of England NHS Foundation Trust, Coventry (G.D.P.), the Centre for Experimental Medicine, Queen's University of Belfast (D.F.M., J.J.M.), and the Regional Intensive Care Unit, the Royal Hospitals (D.F.M., J.J.M.), Belfast, the Department of Critical Care, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham (R.M.L.O.), Intensive Care Unit, Antrim Area Hospital, Antrim (C.L.N.), Intensive Care Unit, Poole Hospital NHS Foundation Trust, Poole (H.R.), and Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds (A.B.) - all in the United Kingdom; and the Department of Medicine, University of California at San Francisco, San Francisco (K.D.L.).
Shalini SanthakumaranFrom the Section of Anaesthetics, Pain Medicine and Intensive Care Medicine, the Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust (A.C.G., F.A.-B., J.B.-L.), Bloomsbury Institute of Intensive Care Medicine, the Division of Medicine, University College London (M.S.), Imperial Clinical Trials Unit Imperial College London (S.S., M.C., F.A.-B., J.B.-L., D.A.), the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (A.J.M.), and the Division of Critical Care, University College London Hospitals (D.B.), London, Warwick Clinical Trials Unit, University of Warwick and Heart of England NHS Foundation Trust, Coventry (G.D.P.), the Centre for Experimental Medicine, Queen's University of Belfast (D.F.M., J.J.M.), and the Regional Intensive Care Unit, the Royal Hospitals (D.F.M., J.J.M.), Belfast, the Department of Critical Care, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham (R.M.L.O.), Intensive Care Unit, Antrim Area Hospital, Antrim (C.L.N.), Intensive Care Unit, Poole Hospital NHS Foundation Trust, Poole (H.R.), and Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds (A.B.) - all in the United Kingdom; and the Department of Medicine, University of California at San Francisco, San Francisco (K.D.L.).
Alexina J MasonFrom the Section of Anaesthetics, Pain Medicine and Intensive Care Medicine, the Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust (A.C.G., F.A.-B., J.B.-L.), Bloomsbury Institute of Intensive Care Medicine, the Division of Medicine, University College London (M.S.), Imperial Clinical Trials Unit Imperial College London (S.S., M.C., F.A.-B., J.B.-L., D.A.), the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (A.J.M.), and the Division of Critical Care, University College London Hospitals (D.B.), London, Warwick Clinical Trials Unit, University of Warwick and Heart of England NHS Foundation Trust, Coventry (G.D.P.), the Centre for Experimental Medicine, Queen's University of Belfast (D.F.M., J.J.M.), and the Regional Intensive Care Unit, the Royal Hospitals (D.F.M., J.J.M.), Belfast, the Department of Critical Care, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham (R.M.L.O.), Intensive Care Unit, Antrim Area Hospital, Antrim (C.L.N.), Intensive Care Unit, Poole Hospital NHS Foundation Trust, Poole (H.R.), and Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds (A.B.) - all in the United Kingdom; and the Department of Medicine, University of California at San Francisco, San Francisco (K.D.L.).
Mary CrossFrom the Section of Anaesthetics, Pain Medicine and Intensive Care Medicine, the Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust (A.C.G., F.A.-B., J.B.-L.), Bloomsbury Institute of Intensive Care Medicine, the Division of Medicine, University College London (M.S.), Imperial Clinical Trials Unit Imperial College London (S.S., M.C., F.A.-B., J.B.-L., D.A.), the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (A.J.M.), and the Division of Critical Care, University College London Hospitals (D.B.), London, Warwick Clinical Trials Unit, University of Warwick and Heart of England NHS Foundation Trust, Coventry (G.D.P.), the Centre for Experimental Medicine, Queen's University of Belfast (D.F.M., J.J.M.), and the Regional Intensive Care Unit, the Royal Hospitals (D.F.M., J.J.M.), Belfast, the Department of Critical Care, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham (R.M.L.O.), Intensive Care Unit, Antrim Area Hospital, Antrim (C.L.N.), Intensive Care Unit, Poole Hospital NHS Foundation Trust, Poole (H.R.), and Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds (A.B.) - all in the United Kingdom; and the Department of Medicine, University of California at San Francisco, San Francisco (K.D.L.).
Farah Al-BeidhFrom the Section of Anaesthetics, Pain Medicine and Intensive Care Medicine, the Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust (A.C.G., F.A.-B., J.B.-L.), Bloomsbury Institute of Intensive Care Medicine, the Division of Medicine, University College London (M.S.), Imperial Clinical Trials Unit Imperial College London (S.S., M.C., F.A.-B., J.B.-L., D.A.), the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (A.J.M.), and the Division of Critical Care, University College London Hospitals (D.B.), London, Warwick Clinical Trials Unit, University of Warwick and Heart of England NHS Foundation Trust, Coventry (G.D.P.), the Centre for Experimental Medicine, Queen's University of Belfast (D.F.M., J.J.M.), and the Regional Intensive Care Unit, the Royal Hospitals (D.F.M., J.J.M.), Belfast, the Department of Critical Care, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham (R.M.L.O.), Intensive Care Unit, Antrim Area Hospital, Antrim (C.L.N.), Intensive Care Unit, Poole Hospital NHS Foundation Trust, Poole (H.R.), and Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds (A.B.) - all in the United Kingdom; and the Department of Medicine, University of California at San Francisco, San Francisco (K.D.L.).
Janis Best-LaneFrom the Section of Anaesthetics, Pain Medicine and Intensive Care Medicine, the Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust (A.C.G., F.A.-B., J.B.-L.), Bloomsbury Institute of Intensive Care Medicine, the Division of Medicine, University College London (M.S.), Imperial Clinical Trials Unit Imperial College London (S.S., M.C., F.A.-B., J.B.-L., D.A.), the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (A.J.M.), and the Division of Critical Care, University College London Hospitals (D.B.), London, Warwick Clinical Trials Unit, University of Warwick and Heart of England NHS Foundation Trust, Coventry (G.D.P.), the Centre for Experimental Medicine, Queen's University of Belfast (D.F.M., J.J.M.), and the Regional Intensive Care Unit, the Royal Hospitals (D.F.M., J.J.M.), Belfast, the Department of Critical Care, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham (R.M.L.O.), Intensive Care Unit, Antrim Area Hospital, Antrim (C.L.N.), Intensive Care Unit, Poole Hospital NHS Foundation Trust, Poole (H.R.), and Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds (A.B.) - all in the United Kingdom; and the Department of Medicine, University of California at San Francisco, San Francisco (K.D.L.).
David BrealeyFrom the Section of Anaesthetics, Pain Medicine and Intensive Care Medicine, the Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust (A.C.G., F.A.-B., J.B.-L.), Bloomsbury Institute of Intensive Care Medicine, the Division of Medicine, University College London (M.S.), Imperial Clinical Trials Unit Imperial College London (S.S., M.C., F.A.-B., J.B.-L., D.A.), the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (A.J.M.), and the Division of Critical Care, University College London Hospitals (D.B.), London, Warwick Clinical Trials Unit, University of Warwick and Heart of England NHS Foundation Trust, Coventry (G.D.P.), the Centre for Experimental Medicine, Queen's University of Belfast (D.F.M., J.J.M.), and the Regional Intensive Care Unit, the Royal Hospitals (D.F.M., J.J.M.), Belfast, the Department of Critical Care, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham (R.M.L.O.), Intensive Care Unit, Antrim Area Hospital, Antrim (C.L.N.), Intensive Care Unit, Poole Hospital NHS Foundation Trust, Poole (H.R.), and Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds (A.B.) - all in the United Kingdom; and the Department of Medicine, University of California at San Francisco, San Francisco (K.D.L.).
Christopher L NuttFrom the Section of Anaesthetics, Pain Medicine and Intensive Care Medicine, the Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust (A.C.G., F.A.-B., J.B.-L.), Bloomsbury Institute of Intensive Care Medicine, the Division of Medicine, University College London (M.S.), Imperial Clinical Trials Unit Imperial College London (S.S., M.C., F.A.-B., J.B.-L., D.A.), the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (A.J.M.), and the Division of Critical Care, University College London Hospitals (D.B.), London, Warwick Clinical Trials Unit, University of Warwick and Heart of England NHS Foundation Trust, Coventry (G.D.P.), the Centre for Experimental Medicine, Queen's University of Belfast (D.F.M., J.J.M.), and the Regional Intensive Care Unit, the Royal Hospitals (D.F.M., J.J.M.), Belfast, the Department of Critical Care, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham (R.M.L.O.), Intensive Care Unit, Antrim Area Hospital, Antrim (C.L.N.), Intensive Care Unit, Poole Hospital NHS Foundation Trust, Poole (H.R.), and Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds (A.B.) - all in the United Kingdom; and the Department of Medicine, University of California at San Francisco, San Francisco (K.D.L.).
James J McNameeFrom the Section of Anaesthetics, Pain Medicine and Intensive Care Medicine, the Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust (A.C.G., F.A.-B., J.B.-L.), Bloomsbury Institute of Intensive Care Medicine, the Division of Medicine, University College London (M.S.), Imperial Clinical Trials Unit Imperial College London (S.S., M.C., F.A.-B., J.B.-L., D.A.), the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (A.J.M.), and the Division of Critical Care, University College London Hospitals (D.B.), London, Warwick Clinical Trials Unit, University of Warwick and Heart of England NHS Foundation Trust, Coventry (G.D.P.), the Centre for Experimental Medicine, Queen's University of Belfast (D.F.M., J.J.M.), and the Regional Intensive Care Unit, the Royal Hospitals (D.F.M., J.J.M.), Belfast, the Department of Critical Care, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham (R.M.L.O.), Intensive Care Unit, Antrim Area Hospital, Antrim (C.L.N.), Intensive Care Unit, Poole Hospital NHS Foundation Trust, Poole (H.R.), and Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds (A.B.) - all in the United Kingdom; and the Department of Medicine, University of California at San Francisco, San Francisco (K.D.L.).
Henrik ReschreiterFrom the Section of Anaesthetics, Pain Medicine and Intensive Care Medicine, the Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust (A.C.G., F.A.-B., J.B.-L.), Bloomsbury Institute of Intensive Care Medicine, the Division of Medicine, University College London (M.S.), Imperial Clinical Trials Unit Imperial College London (S.S., M.C., F.A.-B., J.B.-L., D.A.), the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (A.J.M.), and the Division of Critical Care, University College London Hospitals (D.B.), London, Warwick Clinical Trials Unit, University of Warwick and Heart of England NHS Foundation Trust, Coventry (G.D.P.), the Centre for Experimental Medicine, Queen's University of Belfast (D.F.M., J.J.M.), and the Regional Intensive Care Unit, the Royal Hospitals (D.F.M., J.J.M.), Belfast, the Department of Critical Care, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham (R.M.L.O.), Intensive Care Unit, Antrim Area Hospital, Antrim (C.L.N.), Intensive Care Unit, Poole Hospital NHS Foundation Trust, Poole (H.R.), and Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds (A.B.) - all in the United Kingdom; and the Department of Medicine, University of California at San Francisco, San Francisco (K.D.L.).
Andrew BreenFrom the Section of Anaesthetics, Pain Medicine and Intensive Care Medicine, the Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust (A.C.G., F.A.-B., J.B.-L.), Bloomsbury Institute of Intensive Care Medicine, the Division of Medicine, University College London (M.S.), Imperial Clinical Trials Unit Imperial College London (S.S., M.C., F.A.-B., J.B.-L., D.A.), the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (A.J.M.), and the Division of Critical Care, University College London Hospitals (D.B.), London, Warwick Clinical Trials Unit, University of Warwick and Heart of England NHS Foundation Trust, Coventry (G.D.P.), the Centre for Experimental Medicine, Queen's University of Belfast (D.F.M., J.J.M.), and the Regional Intensive Care Unit, the Royal Hospitals (D.F.M., J.J.M.), Belfast, the Department of Critical Care, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham (R.M.L.O.), Intensive Care Unit, Antrim Area Hospital, Antrim (C.L.N.), Intensive Care Unit, Poole Hospital NHS Foundation Trust, Poole (H.R.), and Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds (A.B.) - all in the United Kingdom; and the Department of Medicine, University of California at San Francisco, San Francisco (K.D.L.).
Kathleen D LiuFrom the Section of Anaesthetics, Pain Medicine and Intensive Care Medicine, the Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust (A.C.G., F.A.-B., J.B.-L.), Bloomsbury Institute of Intensive Care Medicine, the Division of Medicine, University College London (M.S.), Imperial Clinical Trials Unit Imperial College London (S.S., M.C., F.A.-B., J.B.-L., D.A.), the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (A.J.M.), and the Division of Critical Care, University College London Hospitals (D.B.), London, Warwick Clinical Trials Unit, University of Warwick and Heart of England NHS Foundation Trust, Coventry (G.D.P.), the Centre for Experimental Medicine, Queen's University of Belfast (D.F.M., J.J.M.), and the Regional Intensive Care Unit, the Royal Hospitals (D.F.M., J.J.M.), Belfast, the Department of Critical Care, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham (R.M.L.O.), Intensive Care Unit, Antrim Area Hospital, Antrim (C.L.N.), Intensive Care Unit, Poole Hospital NHS Foundation Trust, Poole (H.R.), and Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds (A.B.) - all in the United Kingdom; and the Department of Medicine, University of California at San Francisco, San Francisco (K.D.L.).
Deborah AshbyFrom the Section of Anaesthetics, Pain Medicine and Intensive Care Medicine, the Department of Surgery and Cancer, Imperial College London and Imperial College Healthcare NHS Trust (A.C.G., F.A.-B., J.B.-L.), Bloomsbury Institute of Intensive Care Medicine, the Division of Medicine, University College London (M.S.), Imperial Clinical Trials Unit Imperial College London (S.S., M.C., F.A.-B., J.B.-L., D.A.), the Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (A.J.M.), and the Division of Critical Care, University College London Hospitals (D.B.), London, Warwick Clinical Trials Unit, University of Warwick and Heart of England NHS Foundation Trust, Coventry (G.D.P.), the Centre for Experimental Medicine, Queen's University of Belfast (D.F.M., J.J.M.), and the Regional Intensive Care Unit, the Royal Hospitals (D.F.M., J.J.M.), Belfast, the Department of Critical Care, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham (R.M.L.O.), Intensive Care Unit, Antrim Area Hospital, Antrim (C.L.N.), Intensive Care Unit, Poole Hospital NHS Foundation Trust, Poole (H.R.), and Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds (A.B.) - all in the United Kingdom; and the Department of Medicine, University of California at San Francisco, San Francisco (K.D.L.).
Imperial College London · GBUniversity College London · GBImperial College Healthcare NHS Trust · GBAntrim Area Hospital · GB

Funding

Department of Health NIHR/CS/009/007Medical Research Council MC_G1002460Medical Research Council MC_PC_13093
6 · The paper itself

Abstract

backgroundLevosimendan is a calcium-sensitizing drug with inotropic and other properties that may improve outcomes in patients with sepsis.

methodsWe conducted a double-blind, randomized clinical trial to investigate whether levosimendan reduces the severity of organ dysfunction in adults with sepsis. Patients were randomly assigned to receive a blinded infusion of levosimendan (at a dose of 0.05 to 0.2 μg per kilogram of body weight per minute) for 24 hours or placebo in addition to standard care. The primary outcome was the mean daily Sequential Organ Failure Assessment (SOFA) score in the intensive care unit up to day 28 (scores for each of five systems range from 0 to 4, with higher scores indicating more severe dysfunction; maximum score, 20). Secondary outcomes included 28-day mortality, time to weaning from mechanical ventilation, and adverse events.

resultsThe trial recruited 516 patients; 259 were assigned to receive levosimendan and 257 to receive placebo. There was no significant difference in the mean (±SD) SOFA score between the levosimendan group and the placebo group (6.68±3.96 vs. 6.06±3.89; mean difference, 0.61; 95% confidence interval [CI], -0.07 to 1.29; P=0.053). Mortality at 28 days was 34.5% in the levosimendan group and 30.9% in the placebo group (absolute difference, 3.6 percentage points; 95% CI, -4.5 to 11.7; P=0.43). Among patients requiring ventilation at baseline, those in the levosimendan group were less likely than those in the placebo group to be successfully weaned from mechanical ventilation over the period of 28 days (hazard ratio, 0.77; 95% CI, 0.60 to 0.97; P=0.03). More patients in the levosimendan group than in the placebo group had supraventricular tachyarrhythmia (3.1% vs. 0.4%; absolute difference, 2.7 percentage points; 95% CI, 0.1 to 5.3; P=0.04).

conclusionsThe addition of levosimendan to standard treatment in adults with sepsis was not associated with less severe organ dysfunction or lower mortality. Levosimendan was associated with a lower likelihood of successful weaning from mechanical ventilation and a higher risk of supraventricular tachyarrhythmia. (Funded by the NIHR Efficacy and Mechanism Evaluation Programme and others; LeoPARDS Current Controlled Trials number, ISRCTN12776039 .).

Identifiers

PMID27705084
OpenAlexW2529283167

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.