Interesse di Levosimendan nella riduzione dei fallimenti durante lo svezzamento del supporto vitale extracorporeo - ECLS (Weanilevo)

Inclusion Criteria:

• adult patient

• patient or person responsible for the patient has given written consent

• patient with acute circulatory heart failure under ECLS

• patient meeting criteria for ECLS withdrawal

  • ECLS flow rate at 1.0-1.5l/min and/or ECLS pump rpm ≤ 1500 rpm
  • LVEF > 20% in cardiac ultrasound and aortic ITV > 10 cm
  • VIS score ≤ 10
  • Arterial lactates ≤ 2 mmol/l
  • Right ventricular outflow tract shortening fraction > 30%
  • Basal diameter at the tricuspid telediastolic ring of the right ventricle < 35 mm
  • Fraction of inspired oxygen combined between ventilator and ECLS < 80%

• ECLS withdrawl scheduled within 48 hours

• Absence of an initial or progressive infectious episode (no planned introduction of antibiotic therapy within 48 hours prior to inclusion)

Exclusion Criteria:

• Patient with hepatic insufficiency: cytolysis at least 20 times normal

• Drug intoxication and attempted suicide

• Patient with a contraindication to the use of levosimendan:

  • hypersensitivity to the active substance or any of the excipients
  • severe hypotension and ventricular tachycardia
  • significant mechanical obstructions affecting ventricular filling and/or ejection
  • severe renal failure (creatinine clearance < 30 ml/min)
  • severe liver failure (TP<50%)
  • history of torsades de pointes

• Patient with a contraindication to the use of CERNEVIT®:

  • hypersensitivity to active substances, in particular to vitamin B1 or to one of the excipients or to soy protein products or to peanut protein products
  • hypervitaminosis to any vitamin contained in this formulation
  • severe hypercalcemia, hyper calciuria, tumour, bone metastasis, primary hyperparathyroidism, granulomatosis

• patient not affiliated to or not benefiting from national health insurance

• patient subject to legal protection (curatorship, guardianship)

• patient subject to limited judicial protection

• pregnant, parturient or breastfeeding woman