EurekaMag.com logo
+ Site Statistics
References:
47,893,527
Abstracts:
28,296,643
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on Google+Follow on Google+
Follow on LinkedInFollow on LinkedIn

+ Translate

Levosimendan bei der Therapie der akuten hamodynamisch bedeutsamen Lungenembolie


, : Levosimendan bei der Therapie der akuten hamodynamisch bedeutsamen Lungenembolie. Intensivmedizin und Notfallmedizin 43(8): 636-642

Background Right ventricular competence plays a pivotal role in the clinical course of acute pulmonary embolism. A fatal outcome of an event is mainly due to right heart failure. Levosimendan is a calcium sensitizer, which so far has been evaluated in the setting of left heart failure. We describe the effects of levosimendan in the setting of right heart failure due to acute pulmonary embolism. Methods and results We evaluated the hemodynamic effects and the clinical course of 7 patients in whom therapy of acute pulmonary embolism was augmented by levosimendan. All patients showed echocardiographic signs of right ventricular distension; 6 of the 7 patients showed hypotension with a systemic systolic blood pressure of < 90 mmHg. Under therapy with levosimendan 6 of the 7 cases showed a rapid clinical and hemodynamic recovery, characterized by a significant decrease of systolic pulmonary artery pressure and heart rate within the next 12 and 24 hours. Six patients survived the event. Therapy with levosimendan was not discontinued in any patient. Four patients were treated in addition with fibrinolysis, while 3 patients were treated with heparin alone. In none of these patients was an escalation in therapy required. Conclusion This is a first report of a successful use of levosimendan in the setting of acute right heart failure due to acute pulmonary embolism. Randomized prospective trials are necessary to validate these acute results, to check for side effects and prognostic implications in a larger number of patients, before this kind of therapy can be recommended for regular therapy.


Accession: 012988891

Submit PDF Full Text: Here


Submit PDF Full Text

No spam - Every submission is manually reviewed

Due to poor quality, we do not accept files from Researchgate

Submitted PDF Full Texts will always be free for everyone
(We only charge for PDFs that we need to acquire)

Select a PDF file:
Close
Close

Related references

Wacker, P.; Wacker, R., 2005: Thrombolytische therapie der akuten lungenembolie. The debate about thrombolysis in acute pulmonary embolism (PE) as an adjunctive therapy to heparin is ongoing for about 35 years. Thrombolysis dissolves thromboemboli faster than heparin in combination with spontaneous lysis. So, thrombolysis achi...

Perutz, Alfred, 1931: Zur Pathogenese und Therapie des akuten Ekzems und der akuten Dermatitis,. The wheal test of McClure and Aldrich is inconstant in adult eczema. It constantly shows, however, that disturbances of the tendency to wheal formation and the water metabolism of the skin are present. Milk diet specified by Jean Mayer was tested...

Lichey, J., 2006: Ausschlussidiagnostik der akuten Lungenembolie. Diagnosing or excluding pulmonary embolism on the basis of clinical manifestations alone is difficult because such manifestations are non-specific. Therefore, in more than 50% of cases the diagnosis of acute pulmonary embolism is missed. Patients...

Doerffler-Melly, J.; Amann-Vesti, B., 2007: Diagnostik und Management der akuten Lungenembolie. Only in one fourth to one third of patients admitted for suspected acute pulmonary embolism (PE) is PE objectively confirmed, implying that symptoms and clinical findings of acute PE are nonspecific. Clinical pretest probability for PE may be est...

Wacker, R., 2006: Leitliniengerechtes management der akuten Lungenembolie. Pulmonary embolism (LE) often is characterized by unspecific symptoms, difficult diagnostic work-up, an inconsistant clinical course, and a high mortality. Therefore, acute LE is a challenge for the intensive care medicine. Symptoms with high cli...

Wacker, P.; Wacker, R.; Golnik, R.; Kreft, H.U., 2003: Akute Lungenembolie: Ein neuer Score zur Quantifizierung der akuten Rechtsherzbelastung. In pulmonary embolism, right ventricular dysfunction is decisive for prognosis. Several single parameters are used for description of right ventricular dysfunction, but no quantification of right heart dysfunction has been described up to now. We...

Heering, P.; Brause, M., 2003: Therapie des akuten Nierenversagens: Fussangeln der Therapie. Acute renal failure in intensive care is characterized by mortality rates between 50 and 70%. The remaining mortality was ascribed to different reasons. The number of patients with single organ failure on ICU has decreased but patients with acute...

Aleksic, I.; Kamler, M.; Herold, U.; Massoudy, P.; Jakob, H.-Guenter, 2005: Chirurgische therapie der fulminanten lungenembolie. Surgical embolectomy for massive pulmonary embolism (PE) has become a rare procedure. Often,it is viewed as a last-chance option for patients undergoing cardiopulmonary resuscitation after massive PE. Thus thrombolytic therapy has become the treat...

Anonymous, 2013: Aktuelle Therapie und Sekundarpravention der Lungenembolie. Die Strategien zur Risikostratifizierung und risikoadaptierten Diagnostik und Therapie von Patienten mit Lungenembolie befinden sich aktuell in einer Phase des Umbruchs. F r die neuen europ ischen Leitlinien, die im Jahr 2014 erscheinen sollen, we...

Anonymous, 2007: Therapie der Lungenembolie - Evidenz oder Empirie?