Imperial College London

Professor Anthony Gordon

Faculty of MedicineDepartment of Surgery & Cancer

Chair in Anaesthesia and Critical Care
 
 
 
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Contact

 

+44 (0)20 3312 6328anthony.gordon

 
 
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Location

 

ICUQueen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Gordon:2018,
author = {Gordon, AC and Santhakumaran, S and Al-Beidh, F and Orme, RML and Perkins, GD and Singer, M and McAuley, DF and Mason, AJ and Ward, J and O'Dea, K and Felton, T and Cross, M and Best-Lane, J and Lexow, J and Campbell, A and Ashby, D},
journal = {Efficacy and Mechanism Evaluation},
title = {Levosimendan for the Prevention of Acute oRgan Dysfunction in Sepsis: the LeoPARDS Randomised Controlled Trial},
url = {http://hdl.handle.net/10044/1/61458},
year = {2018}
}

RIS format (EndNote, RefMan)

TY  - JOUR
AB - Background:In septic shock, cardiovascular resuscitation using catecholamine vasopressors and inotropes is standard therapy but catecholamines have important side-effects. Levosimendan is a calcium-sensitizing drug with inotropic and other properties that may have a role in sepsis.Objectives: In adult septic shock1. Does levosimendan reduce the incidence and severity of acute organ dysfunction ?2. What is the effect of levosimendan on individual organ function ?3. What is the safety profile of levosimendan?Design: Multi-centre, randomised, double-blind, parallel-group, placebo-controlled study.Setting: UK Intensive Care UnitsParticipants: Adult patients who have sepsis and cardiovascular failure requiring vasopressors to maintain blood pressure despite adequate fluid resuscitation.Interventions: Levosimendan 0.05 to 0.2 µg/kg/min vs. placebo for 24 hour, in addition to standard care, within 24 hours of meeting inclusion criteria.Primary outcome measure: Mean SOFA score on ICU after randomisation to a maximum of 28 days.Secondary outcome measures: Time to extubationSurvival upto 6 monthsSerious Adverse EventsResults: 2382 patients were screened at 34 centres, of whom 516 were randomised to treatment, 259 allocated to levosimendan and 257 to placebo. Baseline characteristics were well balanced across treatment arms.There was no significant difference in mean (±SD) SOFA score in the levosimendan group (6.7 ± 4.0) compared with placebo (6.1 ± 3.9); (mean difference 0.61, 95%CI -0.07 to 1.29). 28-day mortality was 34.5% versus 30.9% in the levosimendan and placebo groups respectively (absolute difference 3.6%, 95%CI -4.5 to 11.7). Patients in the levosimendan group were less likely to be successfully extubated over 28 days than the placebo group (hazard ratio 0.77, 95%CI 0.60 to 0.97). More patients in the levosimendan group had supraventricular tachyarrhythmias, (3.1% versus 0.4% absolute difference 2.7%, 95%CI 0.1 to 5.3), but there was no
AU - Gordon,AC
AU - Santhakumaran,S
AU - Al-Beidh,F
AU - Orme,RML
AU - Perkins,GD
AU - Singer,M
AU - McAuley,DF
AU - Mason,AJ
AU - Ward,J
AU - O'Dea,K
AU - Felton,T
AU - Cross,M
AU - Best-Lane,J
AU - Lexow,J
AU - Campbell,A
AU - Ashby,D
PY - 2018///
SN - 2050-4365
TI - Levosimendan for the Prevention of Acute oRgan Dysfunction in Sepsis: the LeoPARDS Randomised Controlled Trial
T2 - Efficacy and Mechanism Evaluation
UR - http://hdl.handle.net/10044/1/61458
ER -