Does Levosimendan hasten veno-arterial ECMO weaning? A propensity score matching analysis
Main finding · Successful VA-ECMO weaning (survival without death, heart transplantation or LVAD within 30 days after VA-ECMO withdrawal)Result — go to the resultSHR for successful ECMO weaning 1.45 95% CI 0.77–2.70Authors' conclusion
In patients with non-postoperative cardiogenic shock supported by peripheral VA-ECMO, levosimendan was not associated with increased rates of successful VA-ECMO weaning or improved 30-day and 6-month bridge-free survival.
Study context
- Population
- Patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) for refractory cardiogenic shock, excluding post-cardiotomy shock or end-stage chronic HF
- Participants
- 320 patients · 47 matched pairs
- Exposure
- Levosimendan vs no levosimendan while on VA-ECMO
- Levosimendann = 47
- No-levosimendann = 47reference
- Outcome
- Successful VA-ECMO weaning (survival without death, heart transplantation or LVAD)
- Follow-up
- 30 days after VA-ECMO withdrawal
Methodological detailsbicentric, propensity-score matched
- Bicentric
- Propensity-score matched
Main finding
As reported in the abstract
Successful VA-ECMO weaning (survival without death, heart transplantation or LVAD within 30 days after VA-ECMO withdrawal)
SHR for successful ECMO weaning
1.45
95% CI 0.77–2.70
P = 0.25
Events by group
Levosimendan vs No levosimendan
sHR for successful ECMO weaning 1.45 (95% CI 0.77–2.70); P = 0.25
Observational data: associations, not effects.
Further findings
Bridge-to-heart transplant, LVAD or death
- No significant differences between the groups
Left ventricular ejection fraction and aortic velocity time integral
- Improved significantly after levosimendan in all patients, regardless of weaning status
Original publication
Does Levosimendan hasten veno-arterial ECMO weaning? A propensity score matching analysis. Ann Intensive Care. Published 3 April 2025. doi:10.
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