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Báo cáo y học: "Effect of levosimendan in experimental verapamilinduced myocardial depression"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Effect of levosimendan in experimental verapamilinduced myocardial depression | Kurola et al. Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2010 18 12 SCANDINAVIAN JOURNAL OF Et emergency medicine ORIGINAL RESEARCH Open Access Effect of levosimendan in experimental verapamil-induced myocardial depression Jouni Kurola 1 Heli Leppikangas2 Jarkko Magga1 Leena Lindgren2 Vesa Kiviniemi3 Juha Rutanen1 and Esko Ruokonen1 Abstract Background Calcium antagonist overdose can cause severe deterioration of hemodynamics unresponsible to treatment with beta adrenergic inotropes. The aim of the study was to evaluate in an experimental model the effects of levosimendan during severe calcium antagonist intoxication. Methods Twelve landrace-pigs were intoxicated with intravenous verapamil at escalating infusion rates. The infusion containing 2.5 mg ml verapamil was used aiming to a reduction of cardiac output by 40 from the baseline value. Intoxicated pigs were randomized into two groups control saline and levosimendan intravenous bolus . Inotropic effect was measured as a change in a maximum of the positive slope of the left ventricular pressure LV dP dt . The survival and hemodynamics of the animals were followed for 120 min after the targeted reduction of cardiac output. Results In the control group five out of six pigs died during the experiment. In the levosimendan group one pig died before completion of the experiment p 0.04 . In the levosimendan group a change in LV dP dt was positive in four out of six pigs compared to one out of six pigs in the control group p ns . Conclusions In this experimental model the use of levosimendan was associated with improved survival. Background In the year 2004 more than 10000 toxic exposures to calcium channels blockers were reported in the United States. Of those exposures 3.3 were associated with severe bradycardia hypotension and acute negative inot-ropy. Altogether there were 62 0.6 deaths due to calcium channel blocker overdoses. Verapamil and diltiazem involved the majority of these fatal .