Observational studyCritical care (London, England)2020
Can levosimendan reduce ECMO weaning failure in cardiogenic shock?: a cohort study with propensity score analysis.
Observational study in Critical care (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT04323709 (Levosimendan for Reducing Veno-arterial ECMO Weaning Failure During Refractory Cardiogenic Shock), which is not on this map. Cited by 18 papers, 3 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.
Levosimendan for Reducing Veno-arterial ECMO Weaning Failure During Refractory Cardiogenic Shock: a Retrospective Propensity Score Analysis
Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Clinical outcomes of levosimendan administration in veno-arterial extracorporeal membrane oxygenation: a meta-analysis.BMJ open · 2025Pooled it
- Effects of levosimendan on the outcome of veno-arterial extracorporeal membrane oxygenation: a systematic review and meta-analysis.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Pooled it
- Levosimendan to Facilitate Weaning From Cardiorespiratory Support in Critically Ill Patients: A Meta-Analysis.Frontiers in medicine · 2021Pooled it
- Association between preoperative vasoactive inotropic score and clinical outcomes in severe pneumonia patients with sepsis undergoing extracorporeal membrane oxygenation: an analysis from the Chinese Society of ExtraCorporeal Life Support (CSECLS) Registry.European journal of medical research · 2026Article
- Optimization of Venoarterial Extracorporeal Membrane Oxygenation Weaning: Hemodynamic Targets, Predictive Indicators, and Future Algorithm.Reviews in cardiovascular medicine · 2026Review
- Early use of levosimendan to improve survival and neurological outcomes after cardiac arrest with myocardial dysfunction: a protocol for a randomized controlled trial.Frontiers in cardiovascular medicine · 2026Article
- Effect of Levosimendan Use on All-Cause Mortality in Out-of-Hospital Cardiac Arrest Survivors After Extracorporeal Cardiopulmonary Resuscitation.Biomedicines · 2025Article
- Does Levosimendan hasten veno-arterial ECMO weaning? A propensity score matching analysis.Annals of intensive care · 2025Article
- Levosimendan, a Promising Pharmacotherapy in Cardiogenic Shock: A Comprehensive Review.European cardiology · 2024Review
- Levosimendan in patients undergoing extracorporeal membrane oxygenation after cardiac surgery: an emulated target trial using observational data.Critical care (London, England) · 2023Observational
- The ABCDE approach to difficult weaning from venoarterial extracorporeal membrane oxygenation.Critical care (London, England) · 2022Review
- Extracorporeal Membrane Oxygenation in Infarct-Related Cardiogenic Shock.Journal of clinical medicine · 2022Review
- Levosimendan for VA-ECMO weaning: the silver lining.ESC heart failure · 2022Article
- Levosimendan in intensive care and emergency medicine: literature update and expert recommendations for optimal efficacy and safety.Journal of anesthesia, analgesia and critical care · 2022Review
- Early Levosimendan Administration Improved Weaning Success Rate in Extracorporeal Membrane Oxygenation in Patients With Cardiogenic Shock.Frontiers in cardiovascular medicine · 2022Article
- Levosimendan in venoarterial ECMO weaning. Rational and design of a randomized double blind multicentre trial.ESC heart failure · 2021Article
- Evidence and Current Use of Levosimendan in the Treatment of Heart Failure: Filling the Gap.Drug design, development and therapy · 2021Review
- Correction to: Can levosimendan reduce ECMO weaning failure in cardiogenic shock?: a cohort study with propensity score analysis.Critical care (London, England) · 2020Article
Corrections and comments
- Erratum issued
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVeno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been increasingly used over the last decade in patients with refractory cardiogenic shock. ECMO weaning can, however, be challenging and lead to circulatory failure and death. Recent data suggest a potential benefit of levosimendan for ECMO weaning. We sought to further investigate whether the use of levosimendan could decrease the rate of ECMO weaning failure in adult patients with refractory cardiogenic shock.
methodsWe performed an observational single-center cohort study. All patients undergoing VA-ECMO from January 2012 to December 2018 were eligible and divided into two groups: group levosimendan and group control (without levosimendan). The primary endpoint was VA-ECMO weaning failure defined as death during VA-ECMO treatment or within 24 h after VA-ECMO removal. Secondary outcomes were mortality at day 28 and at 6 months. The two groups were compared after propensity score matching. P < 0.05 was considered statistically significant.
resultsTwo hundred patients were analyzed (levosimendan group: n = 53 and control group: n = 147). No significant difference was found between groups on baseline characteristics except for ECMO duration, which was longer in the levosimendan group (10.6 ± 4.8 vs. 6.5 ± 4.7 days, p < 0.001). Levosimendan administration started 6.6 ± 5.4 days on average following ECMO implantation. After matching of 48 levosimendan patients to 78 control patients, the duration of ECMO was similar in both groups. The rate of weaning failure was 29.1% and 35.4% in levosimendan and control groups, respectively (OR: 0.69, 95%CI: 0.25-1.88). No significant difference was found between groups for all secondary outcomes.
conclusionLevosimendan did not improve the rate of successful VA-ECMO weaning in patients with refractory cardiogenic shock.
trial registrationClinicalTrials.gov, NCT04323709 .
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.