ReviewCureus2026
Levosimendan for Weaning From Veno-Arterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock: An Umbrella Review.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
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.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a key rescue therapy in cardiogenic shock (CS), but weaning failure remains common and is associated with worse outcomes. Levosimendan, a calcium-sensitizing inotrope with vasodilatory and cardioprotective properties, has been proposed to facilitate weaning, and several systematic reviews and meta-analyses with overlapping primary studies have examined this question, with varying conclusions regarding the strength and consistency of the evidence. This umbrella review was conducted to consolidate that evidence base. Following PRISMA 2020 and PRIOR guidelines, PubMed, Embase, Scopus, and Cochrane Library were searched from inception to May 2026 for systematic reviews and meta-analyses evaluating levosimendan as an adjunct for VA-ECMO weaning in adult CS patients. Two reviewers independently screened studies, extracted data, and assessed methodological quality using AMSTAR 2; given substantial overlap in constituent primary studies, a narrative synthesis was performed rather than a de novo meta-analysis. Seven reviews published between 2020 and 2025, pooling 5 to 18 primary studies and 557 to 2,274 patients, met inclusion criteria. All seven reviews found levosimendan significantly improved successful VA-ECMO weaning versus control (OR/RR range 1.20-2.89), with heterogeneity varying across reviews (I² 0-77%), and most also reported a significant reduction in mortality. Secondary outcomes were less consistent, with two reviews reporting numerically longer VA-ECMO support duration or ICU stay in levosimendan-treated patients. AMSTAR 2 confidence ratings ranged from low (n=2) to moderate (n=4) to high (n=1), substantial primary-study overlap was identified across reviews, and GRADE certainty, where formally assessed, was rated very low. Levosimendan may be associated with improved VA-ECMO weaning success and a possible mortality benefit in CS, particularly in patients with combined cardiac insufficiency, but this concordance rests on overlapping, retrospective, non-randomized cohorts, making it hypothesis-generating rather than an evidence-based standard pending adequately powered randomized controlled trials.
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Registered trials
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