Preventive iabp or levosimendan infusion? what is better in high risk patients?
The aim of our study was to compare the efficiency of intraaortic balloon counterpulsation and levosimendan use in patients with low left ventricular ejection fraction (<35%) operated under cardiopulmonary bypass. The study included 90 patients who were randomized into three groups depending on the strategy of hemodynamic support. In group A patients received IABP a day before the operation. In group B preventive IABP was combined with intraoperative levosimendan infusion. In group C patients received only intraoperative infusion of levosimendan. Hemodynamics, markers of myocardial damage and heart failure, postoperative complications and length of hospital stay were observed. Patients treated with levosimendan, had a more stable hemodynamic profile. Troponin I level was significantly lower in the group C 6 hours after cardiopulmonary bypass compared with the group A. Length of stay in intensive care significantly lower in the group C. The preoperative concentration of BNP (> or = 360 pg/ml) is a predictor of inotropic support in the postoperative period. The results of our study indicate that the use of levosimendan in high risk patients is effective and shows results comparable with intra-aortic balloon counterpulsation