Esized that mortality in REVIVE will be equivalent to ADHERE in all CARTdefined risk subgroups. Methods REVIVE (n = 700) mortality data were mapped making use of the identical variables/cut-points as the ADHERE CART evaluation. Benefits Compared with ADHERE, proportionately extra individuals in REVIVE had SBP <115 mmHg (56.4 vs 18.6 ; P < 0.001) with more patients (3.0 vs 1.9 ; P < 0.05) in the highest mortality risk subgroup (SBP <115 mmHg, BUN 43 mg/dl, and Cr 2.75 mg/dl). For the total population and for every CART-defined subgroup, REVIVE inhospital mortality rates were lower than those from ADHERE. See Figure 1.SCritical CareMarch 2007 Vol 11 Suppl27th International Symposium on Intensive Care and Emergency MedicineFigure 1 (abstract P223)Figure 1 (abstract P224)Mortality rates from REVIVE for subgroups defined by the ADHERE classification and regression tree model.Conclusion Clinical trials (REVIVE) may enroll proportionately more patients at increased risk of mortality in comparison with the general population (ADHERE). Despite the predicted increased mortality risk, mortality rates were lower in REVIVE than in ADHERE for the total population and for every CART-defined risk subgroup. Differences in SOC or additional risk factors, such as age or other comorbid conditions, may contribute to the poorer prognosis in nontrial populations.different mechanism of action. Catecholamines increase Ca2+ availability and LS increases myocardial cell calcium sensibility.P225 Retrospective study of proarrhythmic effects of levosimendan during the therapy of heart failureE Zima, G Szucs, A Soltesz, D Becker, G Fulop, L Molnar, G Barczi, B Merkely Semmelweis University, Budapest, Hungary Critical Care 2007, 11(Suppl 2):P225 (doi: 10.1186/cc5385) Introduction Levosimendan is a new, effective inodilator agent, which is a new alternate drug beside conventional inotropic drugs in treatment of acute and chronic heart failure. Positive inotropic effects of levosimendan is based on myocardial Ca-sensitising. Few clinical data are available about the occurrence of proarrhythmic effects of levosimendan, particularly administered in parallel with catecholamines. Method From PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20738431 1 January 2006 until 30 July, 41 levosimendantreated patients’ information were processed in our retrospective study. Indication of levosimendan therapy was acute heart failure Tanshinone IIA site resulting from myocardial infarction in 23 instances and acute progression of chronic heart failure (NYHA III V) in 18 circumstances. Following a 10-minute bolus levosimendan infusion was administered at rate of 0.1 /kg/min for six hours and 24 hours in every single group, respectively. We investigated the occurrence of sustained ventricular or supraventricular arrhythmias for the very first 48 hours from the beginning of infusion. Results The ratio of hypertension, diabetes, earlier myocardial infarction and ACBG were 58 , 27 , 32 and 15 , respectively, in the monitored population (13 females, 28 males; imply age: 68 years). 3 ventricular arrhythmias and one particular supraventricular arrhythmia had been observed during the 48-hour period, all of them occurred in acute heart failure sufferers with acute myocardial infarction. Parallel usage of catecholamines (noradrenalin and/or dopamine) and levosimendan therapy was observed in three cases, in one of them ventricular tachycardia was observed 3 hours soon after starting levosimendan infusion. No arrhythmia was observed in chronic heart failure individuals. The incidence of proarrhythmic effects throughout levosimendan therapy was 9.75 from the whole.
