Table 1.
Description of the population included at the beginning of ECMO support
| Levosimendan | p-value | ||||
|---|---|---|---|---|---|
| No (n = 174) | Yes (n = 65) | ||||
| On admission | |||||
| Age (years) | Median [Q1–Q3] | 62 [54–70] | 62 [58–72] | 0.725 | |
| Sex | Female | 67 (39%) | 22 (34%) | 0.507 | |
| BMI (Kg/m2) | Median [Q1–Q3] | 27 [24-31] | 25 [22–28] | 0.015 | |
| N (NA) | 173 (1) | 65 (0) | |||
| Medical conditions | Hypertension | 99 (57%) | 36 (55%) | 0.834 | |
| Diabetes | 40 (23%) | 20 (31%) | 0.217 | ||
| Dyslipidemia | 59 (34%) | 26 (40%) | 0.381 | ||
| COPD | 18 (10%) | 6 (9%) | 0.799 | ||
| Peripheral vascular disease | 16 (9%) | 9 (14%) | 0.278 | ||
| N (NA) | 175 (0) | 64 (1) | |||
| Chronic heart failure | 131 (78%) | 49 (77%) | 0.758 | ||
| N (NA) | 168 (7) | 64 (1) | |||
| Previous sternotomy | 67 (39%) | 20 (31%) | 0.269 | ||
| Chronic kidney disease | 49 (28%) | 18 (28%) | 0.943 | ||
| SAPS II | Median [Q1–Q3] | 24 [5–51] | 56 [13–64] | 0.0004 | |
| N (NA) | 173 (1) | 64 (1) | |||
| Euroscore | Median [Q1–Q3] | 3.9 [2–10.3] | 6.4 [2-25] | 0.047 | |
| N (NA) | 172 (8) | 64 (4) | |||
| Type of surgery | CABG | 13 (7%) | 10 (15%) | 0.262 | |
| Valvular surgery | 55 (32%) | 18 (28%) | |||
| Combined valvular and CABG | 20 (11%) | 4 (6%) | |||
| Heart transplant | 65 (37%) | 26 (40%) | |||
| LVAD | 0 (0%) | 1 (2%) | |||
| TAVI | 1 (1%) | 0 (0%) | |||
| Other | 20 (11%) | 6 (9″) | |||
| In the operating room | |||||
| CPB duration (minutes) | Median [Q1–Q3] | 142 [110–180] | 136 [98–190] | 0.463 | |
| N (NA) | 172 (2) | 65 (0) | |||
| Aortic cross-clamping (minutes) | Median [Q1–Q3] | 85 [67–124] | 77 [55–127] | 0.292 | |
| N (NA) | 163 (11) | 62 (3) | |||
| RBC (units) | Median [Q1–Q3] | 2 [0–6] | 2 [0–5] | 0.552 | |
| N (NA) | 169 (5) | 64 (1) | |||
| Frozen plasma (units) | Median [Q1–Q3] | 3 [0–6] | 2 [0–6] | 0.224 | |
| N (NA) | 169 (5) | 64 (1) | |||
| Platelets (units) | Median [Q1–Q3] | 1 [0–1] | 1 [0–1] | 0.660 | |
| N (NA) | 169 (5) | 64 (1) | |||
| Fibrinogen | Yes | 57 (34%) | 20 (31%) | 0.741 | |
| N (NA) | 171 (4) | 64 (1) | |||
| At ECMO implantation | |||||
| Timing | Intraoperative | 126 (72%) | 51 (78%) | 0.3425 | |
| Postoperative | 48 (28%) | 14 (22%) | |||
| Ventricular failure at implantation | Left | 28 (16%) | 22 (34%) | 0.008 | |
| Right | 20 (11%) | 8 (12%) | |||
| Right and left | 126 (72%) | 35 (54%) | |||
| ECMO site | Central | 13 (7%) | 3 (5%) | 0.568 | |
| SOFA | Median [Q1–Q3] | 11 [10–13] | 11 [10–12] | 0.341 | |
| N (NA) | 136 (38) | 57 (8) | |||
| Daily total dose of epinephrine (mg) | Mean (SD) | 13 (27.9) | 6.8 (15.2) | 0.070 | |
| N (NA) | 172 (2) | 65 (0) | |||
| Daily total dose of norepinephrine (mg) | Median [Q1–Q3] | 17.6 [6.2–42.2] | 15.4 [4.1–38.1] | 0.312 | |
| N (NA) | 172 (2) | 65 (0) | |||
| Daily total dose of dobutamine (mg) | Median [Q1–Q3] | 226.3 [0–517.3] | 365.5 [28.1–615.6] | 0.041 | |
| N (NA) | 172 (2) | 65 (0) | |||
| VIS | Median [Q1–Q3] | 26.8 [13.3–52.9] | 23.6 [13.8–40.4] | 0.275 | |
| N (NA) | 172 (2) | 65 (0) | |||
| Lactate | Median [Q1–Q3] | 5.6 [3.4–8.9] | 5.3 [3–7.9] | 0.160 | |
| N (NA) | 157 (17) | 59 (6) | |||
| ECMO output (L/min/m2) | Median [Q1–Q3] | 1.8 [1.5–2.1] | 1.9 [1.4–2.2] | 0.686 | |
| N (NA) | 131 (43) | 55 (10) | |||
| Impella® | Yes | 12 (7%) | 4 (6%) | 1.000 | |
| Delay between CPB cessation and ECMO implantation (hours) | Mean (SD) | 8.4 (26.4) | 7.4 (28.5) | 0.295 | |
| N (NA) | 163 (11) | 64 (1) | |||
| Delay between ECMO implantation and levosimendan infusion (days) | Median [Q1–Q3] | - | 5 [3–6] | ||
| Events under ECMO | IABP | 73 (42%) | 27 (42%) | 0.954 | |
| Digestive bleeding | 25 (14%) | 13 (20%) | 0.289 | ||
| Acute mesenteric ischemia | 37 (22%) | 5 (8%) | 0.014 | ||
| N (NA) | 173 (2) | 64 (1) | |||
| Acute kidney injury | 136 (79%) | 44 (68%) | 0.0804 | ||
| N (NA) | 174 (1) | 64 (1) | |||
| Extra-renal replacement therapy | 96 (55%) | 33 (51%) | 0.543 | ||
| Stroke | 13 (7%) | 13 (20%) | 0.006 | ||
| Mediastinitis | 15 (9%) | 10 (15%) | 0.128 | ||
| Bacteremia | 52 (30%) | 27 (42%) | 0.088 | ||
| Septic shock | 85 (49%) | 36 (55%) | 0.369 | ||
| Hemorrhagic shock | 83 (48%) | 30 (46%) | 0.831 | ||
| Cardiac arrest | 29 (17%) | 8 (12%) | 0.407 | ||
| Acute coronary syndrome | 14 (8%) | 1 (2%) | 0.076 | ||
| VAP | 110 (63%) | 47 (72%) | 0.188 | ||
| Limb ischemia | 25 (15%) | 8 (13%) | 0.708 | ||
| N (NA) | 172 (3) | 63 (2) | |||
| Scarpa infection | 18 (11%) | 8 (13%) | 0.650 | ||
| N (NA) | 161 (4) | 63 (2) | |||
| Surgical revision of the ECMO implantation site | 26 (15%) | 10 (16%) | 0.937 | ||
| N (NA) | 172 (3) | 64 (1) | |||
BMI, body mass index; CABG, coronary artery bypass graft; CPB, cardiopulmonary bypass; COPD, chronic obstructive pulmonary disease; ECMO, extracorporeal membrane oxygenation; IABP, intra-aortic balloon pump; LVAD, left ventricular assist device; NA, not available (missing data); Q1, first quartile; Q3, third quartile; RBC, red blood cells; SAPS II, Simplified Acute Physiology Score II; SOFA, Sequential Organ Failure Assessment; TAVI, transcatheter aortic valve implantation; VAP, ventilator-associated pneumonia; VIS, vasoactive inotropic score. For covariates which the median was null in both groups, they were described with their mean and standard deviation