ArticleESC heart failure2021
Levosimendan in venoarterial ECMO weaning. Rational and design of a randomized double blind multicentre trial.
Article in ESC heart failure, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04158674 (Interest of Levosimendan in Reducing Weaning Failures of ExtraCorporeal Life Support - ECLS. Randomized, Controlled, Multicenter, Double-blind, Multicenter Clinical Trial), which is not on this map. Cited by 18 papers, 2 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.
Interest of Levosimendan in Reducing Weaning Failures of ExtraCorporeal Life Support - ECLS. Randomized, Controlled, Multicenter, Double-blind, Multicenter Clinical Trial
Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 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 in Cardiogenic Shock: A Review of Mechanisms, Clinical Evidence, and Therapeutic Use.Reviews in cardiovascular medicine · 2026Review
- Optimization of Venoarterial Extracorporeal Membrane Oxygenation Weaning: Hemodynamic Targets, Predictive Indicators, and Future Algorithm.Reviews in cardiovascular medicine · 2026Review
- Effect of Levosimendan Use on All-Cause Mortality in Out-of-Hospital Cardiac Arrest Survivors After Extracorporeal Cardiopulmonary Resuscitation.Biomedicines · 2025Article
- Predictors for Successful Weaning from Veno-Venous Extracorporeal Membrane Oxygenation in Patients with Severe Acute Respiratory Distress Syndrome.Risk management and healthcare policy · 2025Article
- Mechanical circulatory support for high-risk surgical aortic valve and ascending aortic replacement in severe bicuspid aortic valve stenosis: a case series.European heart journal. Case reports · 2024Article
- Intravenous Levosimendan versus Inhalational Milrinone in the Management of Pulmonary Hypertension during Adult Cardiac Surgery: A Randomized Clinical Trial.Life (Basel, Switzerland) · 2024Article
- Overview of the current use of levosimendan in France: a prospective observational cohort study.Annals of intensive care · 2023Article
- Monitoring of Levosimendan Administration in Patients with Pulmonary Hypertension Undergoing Cardiac Surgery and Effect of Two Different Dosing Schemes on Hemodynamic and Echocardiographic Parameters.Pharmaceuticals (Basel, Switzerland) · 2023Article
- Population Pharmacokinetics of Levosimendan and its Metabolites in Critically Ill Neonates and Children Supported or Not by Extracorporeal Membrane Oxygenation.Clinical pharmacokinetics · 2023Article
- Current and future options for adult biventricular assistance: a review of literature.Frontiers in cardiovascular medicine · 2023Review
- Determinants of Arterial Pressure of Oxygen and Carbon Dioxide in Patients Supported by Veno-Arterial ECMO.Journal of clinical medicine · 2022Article
- 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
- Evaluation of the Oxiris Membrane in Cardiogenic Shock Requiring Extracorporeal Membrane Oxygenation Support: Study Protocol for a Single Center, Single-Blind, Randomized Controlled Trial.Frontiers in cardiovascular medicine · 2021Article
Corrections and comments
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Authors and funding
12 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsVenoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly being used in circulatory failure. The main indications are cardiogenic shock, post-cardiotomy cardiac failure, and refractory cardiac arrest. However, VA-ECMO weaning is particularly challenging, and weaning failure is reported to be as high as 50%, with increased related mortality. Levosimendan is a novel long acting effect inodilator used in cardiogenic shock and terminal heart failure decompensation. Levosimendan use in VA-ECMO patients seems to reduce weaning failure regardless of the initial aetiology and to reduce mortality when administrated early after VA-ECMO initiation. However, studies are limited to retrospective analyses and reported case series. The aim of the WEANILEVO trial is to evaluate whether administration of levosimendan before VA-ECMO weaning is associated with a reduced rates of weaning failure and recourse to other temporary circulatory support. METHODS AND
resultsWEANILEVO is a randomized, prospective, multicentre, double-blind, parallel-group, controlled trial. One hundred eighty patients will be enrolled if they had acute circulatory heart failure treated with VA-ECMO and for whom weaning is expected within 48 h. The study drugs are either levosimendan (0.2 μg/kg/min for 24 h) or a placebo. The primary endpoint of the trial is the absence of VA-ECMO weaning, recourse to another VA-ECMO, or other temporary circulatory assistance or death within 7 days of VA-ECMO weaning.
conclusionsLevosimendan use in VA-ECMO appears to be beneficial for reducing weaning failure and mortality. The results of WEANILEVO should significantly influence decisions regarding the use of levosimendan for VA-ECMO weaning.
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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.