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{Antcliffe:2019:10.1007/s00134-019-05731-w,
author = {Antcliffe, DB and Santhakumaran, S and Orme, RML and Ward, JK and Al-Beidh, F and ODea, K and Perkins, GD and Singer, M and McAuley, DF and Mason, AJ and Cross, M and Ashby, D and Gordon, AC},
doi = {10.1007/s00134-019-05731-w},
journal = {Intensive Care Medicine},
pages = {1392--1400},
title = {Levosimendan in septic shock in patients with biochemical evidence of cardiac dysfunction: a subgroup analysis of the LeoPARDS randomised trial},
url = {http://dx.doi.org/10.1007/s00134-019-05731-w},
volume = {45},
year = {2019}
}

RIS format (EndNote, RefMan)

TY  - JOUR
AB - PurposeMyocardial dysfunction is common in sepsis but optimal treatment strategies are unclear. The inodilator, levosimendan was suggested as a possible therapy; however, the levosimendan to prevent acute organ dysfunction in Sepsis (LeoPARDS) trial found it to have no benefit in reducing organ dysfunction in septic shock. In this study we evaluated the effects of levosimendan in patients with and without biochemical cardiac dysfunction and examined its non-inotropic effects.MethodsTwo cardiac biomarkers, troponin I (cTnI) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP), and five inflammatory mediators were measured in plasma from patients recruited to the LeoPARDS trial at baseline and over the first 6 days. Mean total Sequential Organ Failure Assessment (SOFA) score and 28-day mortality were compared between patients with normal and raised cTnI and NT-proBNP values, and between patients above and below median values.ResultsLevosimendan produced no benefit in SOFA score or 28-day mortality in patients with cardiac dysfunction. There was a statistically significant treatment by subgroup interaction (p = 0.04) in patients with NT-proBNP above or below the median value. Those with NT-proBNP values above the median receiving levosimendan had higher SOFA scores than those receiving placebo (mean daily total SOFA score 7.64 (4.41) vs 6.09 (3.88), mean difference 1.55, 95% CI 0.43–2.68). Levosimendan had no effect on the rate of decline of inflammatory biomarkers.ConclusionAdding levosimendan to standard care in septic shock was not associated with less severe organ dysfunction nor lower mortality in patients with biochemical evidence of cardiac dysfunction.
AU - Antcliffe,DB
AU - Santhakumaran,S
AU - Orme,RML
AU - Ward,JK
AU - Al-Beidh,F
AU - ODea,K
AU - Perkins,GD
AU - Singer,M
AU - McAuley,DF
AU - Mason,AJ
AU - Cross,M
AU - Ashby,D
AU - Gordon,AC
DO - 10.1007/s00134-019-05731-w
EP - 1400
PY - 2019///
SN - 0342-4642
SP - 1392
TI - Levosimendan in septic shock in patients with biochemical evidence of cardiac dysfunction: a subgroup analysis of the LeoPARDS randomised trial
T2 - Intensive Care Medicine
UR - http://dx.doi.org/10.1007/s00134-019-05731-w
UR - https://link.springer.com/article/10.1007%2Fs00134-019-05731-w
UR - http://hdl.handle.net/10044/1/72773
VL - 45
ER -