Effects of Levosimendan Combined with Routine Therapy on Markers for Cardiac Function, Inflammatory Factors, And Apache Ii Score in Patients with Septic Shock

Tianquan Yin, Yan Liu, Cheng Zhao, Shubin Guo^*

Department of Emergency, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, P.R.China

Objective: The aim of this study was to investigate the effects of levosimendan combined with routine therapy on markers for cardiac function, inflammatory factors, and Acute Physiology And Chronic Health Evaluation II (APACHE II) score in patients with septic shock (SS).

Methods: We randomly assigned 118 patients with SS admitted to our hospital to receive levosimendan combined with routine therapy (68 cases, the research group, RG) or to receive routine therapy (50 cases, the control group, CG). The two groups were compared in the markers for cardiac function, the infection indexes, the blood flow capacity, the inflammatory factors, and the APACHE II score before and after treatment. The treatment responses in the two groups were recorded.

Results: After treatment, the cardiac index (CI) and left ventricular ejection fraction (LVEF) were higher in RG than in CG (P < 0.05), while the left ventricular end-systolic diameter (LVESd) and left ventricular end-diastolic diameter (LVEDd) were lower in RG than in CG (P < 0.05). Patients from RG had lower concentrations of N-type brain natriuretic peptide (BNP), troponin I (TnI), hypersensitive C-reactive protein (hs-CRP), and procalcitonin (PCT) than patients from CG after treatment (P < 0.05). After treatment, compared to CG, RG had lower heart rate (HR, P < 0.05), higher mean arterial pressure (MAP, P < 0.05), and lower central venous pressure (CVP, P < 0.05). After treatment, RG had markedly lower levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) (P < 0.05), and higher interleukin-10 (IL-10) level than CG (P < 0.05). The treatment efficacy in RG was superior over that in CG (P < 0.05). The APACHE II score was lower in RG than in CG (P < 0.05).

Conclusion: Levosimendan combined with routine therapy is highly effective in the treatment of SS. It can improve the expression of markers for cardiac function and inflammatory factors in patients, and reduce the APACHE II score, which is worthy of clinical popularization.