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10.1136/bmjopen-2017-019338 http://scihub22266oqcxt.onion/10.1136/bmjopen-2017-019338 C5884355!5884355 !29602841     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=29602841 &cmd=llinks): Failed to open stream: HTTP request failed! 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Effect of levosimendan on mortality in severe sepsis and septic shock: a meta-analysis of randomised trials |pdf=|usr=}}{{29602841 }} gab.com Text Effect of levosimendan on mortality in severe sepsis and septic shock: a meta-analysis of randomised trials JO: BMJ Open http://www.kidney.de/pget.php?&tw=1&pmid=29602841 #FOAvip OBJECTIVE: We aim to synthesise up-to-date randomised trials to investigate the effects of levosimendan on mortality and clinical outcomes in severe sepsis and septic shock. METHODS: A collection of databases including PubMed, EMBASE, Cochrane Central Register and Web of Science were searched updated to August 2017. Randomised trials were included when they pertain to the use of levosimendan in severe sepsis or septic shock compared with any category of inotropes, or as an adjunct to standard therapy with mortality reported. The primary outcome was mortality, and the secondary outcomes were clinical performances including serum lactate, cardiac function, vasopressor requirement and fluid infusion. RESULTS: A total of 10 studies with 1036 patients were included in this meta-analysis. The results revealed that levosimendan could not reduce mortality significantly in severe sepsis and septic shock (OR 0.89, 95%?CI 0.69 to 1.16, P=0.39). Levosimendan use could reduce serum lactate more effectively, and enhance cardiac contractibility with increased cardiac index and left ventricular ejection fraction. However, its use could also increase fluid infusion but not reduce norepinephrine dose. No significant benefit in mortality could be observed of levosimendan versus dobutamine use, or in patients with proven cardiac dysfunction. CONCLUSIONS: Current evidence is not sufficient to support levosimendan as superior to dobutamine or as an optimal adjunct in severe sepsis and septic shock. More large-scale randomised trials are necessary to validate levosimendan use in sepsis. Twit Text FOAVip Effect of levosimendan on mortality in severe sepsis and septic shock: a meta-analysis of randomised trials ????BMJ Open http://www.kidney.de/pget.php?&tw=1&pmid=29602841 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=29602841 #FOAvip English Wikipedia <ref>{{Cite pmid|29602841 }}</ref> Effect of levosimendan on mortality in severe sepsis and septic shock: a meta-analysis of randomised trials #MMPMID29602841 Chang W ; Xie JF ; Xu JY ; Yang Y BMJ Open 2018[Mar]; 8 (3 ): e019338 PMID29602841 show ga OBJECTIVE: We aim to synthesise up-to-date randomised trials to investigate the effects of levosimendan on mortality and clinical outcomes in severe sepsis and septic shock. METHODS: A collection of databases including PubMed, EMBASE, Cochrane Central Register and Web of Science were searched updated to August 2017. Randomised trials were included when they pertain to the use of levosimendan in severe sepsis or septic shock compared with any category of inotropes, or as an adjunct to standard therapy with mortality reported. The primary outcome was mortality, and the secondary outcomes were clinical performances including serum lactate, cardiac function, vasopressor requirement and fluid infusion. RESULTS: A total of 10 studies with 1036 patients were included in this meta-analysis. The results revealed that levosimendan could not reduce mortality significantly in severe sepsis and septic shock (OR 0.89, 95%?CI 0.69 to 1.16, P=0.39). Levosimendan use could reduce serum lactate more effectively, and enhance cardiac contractibility with increased cardiac index and left ventricular ejection fraction. However, its use could also increase fluid infusion but not reduce norepinephrine dose. No significant benefit in mortality could be observed of levosimendan versus dobutamine use, or in patients with proven cardiac dysfunction. CONCLUSIONS: Current evidence is not sufficient to support levosimendan as superior to dobutamine or as an optimal adjunct in severe sepsis and septic shock. More large-scale randomised trials are necessary to validate levosimendan use in sepsis. |*Cardiotonic Agents/therapeutic use [MESH] |*Sepsis/drug therapy [MESH] |*Shock, Septic/drug therapy [MESH] |*Simendan/therapeutic use [MESH] |Humans [MESH] |Hydrazones [MESH] |Pyridazines [MESH]Effect of levosimendan on mortality in severe sepsis and septic shock:(epmc).pdf DeepDyve Pubget Overpricing