دورية أكاديمية
Effects of levosimendan on cellular metabolic alterations in patients with septic shock. a randomized controlled pilot study
| العنوان: | Effects of levosimendan on cellular metabolic alterations in patients with septic shock. a randomized controlled pilot study |
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| المؤلفون: | Hajjej, Zied, Meddeb, Bilel, Sellami, Walid, Labbene, Iheb, Morelli, Andrea, Ferjani, Mustapha |
| المساهمون: | Hajjej, Zied, Meddeb, Bilel, Sellami, Walid, Labbene, Iheb, Morelli, Andrea, Ferjani, Mustapha |
| بيانات النشر: | Wolters Kluwer Health, Inc. on behalf of the Shock Society. Augusta |
| سنة النشر: | 2017 |
| المجموعة: | Sapienza Università di Roma: CINECA IRIS |
| مصطلحات موضوعية: | levosimendan, metabolism, microcirculation, microdialysi, septic shock, emergency medicine, critical care and intensive care medicine |
| الوصف: | Introduction: Mitochondrial dysfunction and consequent cellular energetic failure play a key role in the development of sepsis-related organs failure. Evidence suggests that the pleiotropic effects of levosimendan may positively affect cellular metabolism during septic shock. Objectives: To investigate changes in the concentration of glucose, lactate, pyruvate, and glycerol in the extracellular fluid of the skeletal muscle following levosimendan administration in patients with septic shock. Methods: The study was designed as a prospective, double-blind, controlled, clinical pilot trial and performed in a multidisciplinary intensive care unit. After achieving normovolemia and a mean arterial pressure of at least 65 mm Hg, 20 septic shock patients were randomized to receive either levosimendan 0.2 mu g/kg/min (n = 10), or dobutamine 5 mu g/kg/min as active comparator (n = 10). Interstitial tissue concentrations of lactate, pyruvate, glucose, and glycerol were obtained by using muscle microdialysis. All measurements, including data from right heart catheterization, were obtained at baseline and every 6 h for the following 72 h after randomization. The trial is registered with Clinicaltrials.gov, number NCT02963454. Results: Compared with dobutamine, levosimendan increased interstitial tissue pyruvate concentration (153.3 +/- 73 and 187.2 +/- 13.5 vs. 210.7 +/- 76.2 and 161 +/- 64.6; P< 0.05), and lactate clearance (55 vs. 10). Lactate/pyruvate ratio was lower in the levosimendan group at the end of study period (37.7 +/- 18.9 and 29.3 +/- 12.7 vs. 10.9 +/- 4.5 and 31.4 +/- 13.2; P< 0.05). Conclusion: Although we investigated a small number of patients, our preliminary results suggest that levosimendan may improve cellular metabolic alterations in patients with septic shock. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | STAMPA |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/28234790; info:eu-repo/semantics/altIdentifier/wos/WOS:000407581500006; volume:48; issue:3; firstpage:307; lastpage:312; numberofpages:6; journal:SHOCK; http://hdl.handle.net/11573/1087935Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85013748741; http://journals.lww.com/shockjournalTest |
| DOI: | 10.1097/SHK.0000000000000851 |
| الإتاحة: | https://doi.org/10.1097/SHK.0000000000000851Test http://hdl.handle.net/11573/1087935Test http://journals.lww.com/shockjournalTest |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.3BBD2C9B |
| قاعدة البيانات: | BASE |
| DOI: | 10.1097/SHK.0000000000000851 |
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