Effect of levosimendan on the overall mortality in patients with severe sepsis or septic shock: a meta-analysis

doi:10.3877/cma.j.issn.1674-6880.2017.04.008

Abstract

Abstract:

Objective

To assess the effect of levosimendan on the overall mortality in patients with severe sepsis or septic shock.

Methods

Randomized controlled trials focused on the effects of levosimendan treatment (experiment group) and traditional treatment (control group) on the overall mortality in adult patients with severe sepsis or septic shock were systematically retrieved from PubMed, OVID, Cochrane Library, Wanfang data, CNKI, VIP net and Chinese Biomedical Database from database inception to December 2016. Two reviewers independently screened articles according to the inclusion and exclusion criteria, extracted the data and evaluated the quality of the included studies. The mate-analysis was performed by Stata/SE 11.0 software, funnel plots were drawn to detect the publication bias.

Results

A total of 831 patients in 10 studies were included. Meta-analysis indicated that the overall mortality in the experiment group showed no significant difference as compared to the control group [OR = 0.95, 95%CI (0.71, 1.27), Z = 0.36, P = 0.721], the funnel plots demonstrated publication bias. Meanwhile, there was also no significant difference in the duration of intensive care unit stay between the two groups [SMD =-0.24, 95%CI (-0.56, 0.07), Z = 1.51, P = 0.131].

Conclusion

Levosimendan can't improve the overall mortality in patients with severe sepsis or septic shock.

Key words: Levosimendan, Sepsis, Shock, speptic, Mortality, Meta-analysis

Xiaoyang Zhou, Zhaojun Xu, Peng Liu, Yuchu Zhang, Qun Yang, Xujun Hu, Peifu Chen. Effect of levosimendan on the overall mortality in patients with severe sepsis or septic shock: a meta-analysis[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2017, 10(04): 252-257.

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References 28

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纳入文献	样本量（例）		年龄[ ± s或M（P₂₅，P₇₅）]		性别[例（男/女）]		APACHEⅡ评分[分， ± s或M（P₂₅，P₇₅）]		Jadad评分（分）
纳入文献	实验组	对照组	实验组	对照组	实验组	对照组	实验组	对照组	Jadad评分（分）
Gordon等2016^[7]	258	256	67（58，75）	69（58，77）	145/113	144/112	25（21，31）	25（21，30）	7
Meng等2016^[8]	19	19	55 ± 18	50 ± 14	13/6	11/8	18.4 ± 4.5	19.5 ± 4.3	4
Torraco等2014^[5]	13	13	70（58，80）	68（57，79）	11/2	8/5	-	-	1
Memis等2012^[11]	15	15	55 ± 19	56 ± 15	8/7	8/7	30.1 ± 7.6	27.0 ± 8.5	1
Morelli等2010^[12]	20	20	68（55，74）	66（54，78）	14/6	13/7	-	-	4
Morelli等2005^[13]	15	15	61.5 ± 7.0	62 ± 7	11/4	12/3	24.4 ± 1.6	23.7 ± 2.1	3
黄河等2015^[14]	26	25	66 ± 3	66 ± 5	15/11	15/10	23.7 ± 6.8	24.5 ± 6.9	1
方明星等2014^[15]	18	18	61 ± 7	62 ± 7	14/4	13/5	23.5 ± 2.4	24.1 ± 2.1	3
刁井地等2014^[16]	19	19	-	-	-	-	19.6 ± 5.9	20.3 ± 4.8	1
赵湛元2013^[17]	15	15	-	-	-	-	-	-	1

纳入文献	样本量（例）		年龄[ ± s或M（P₂₅，P₇₅）]		性别[例（男/女）]		APACHEⅡ评分[分， ± s或M（P₂₅，P₇₅）]		Jadad评分（分）
纳入文献	实验组	对照组	实验组	对照组	实验组	对照组	实验组	对照组	Jadad评分（分）
Gordon等2016^[7]	258	256	67（58，75）	69（58，77）	145/113	144/112	25（21，31）	25（21，30）	7
Meng等2016^[8]	19	19	55 ± 18	50 ± 14	13/6	11/8	18.4 ± 4.5	19.5 ± 4.3	4
Torraco等2014^[5]	13	13	70（58，80）	68（57，79）	11/2	8/5	-	-	1
Memis等2012^[11]	15	15	55 ± 19	56 ± 15	8/7	8/7	30.1 ± 7.6	27.0 ± 8.5	1
Morelli等2010^[12]	20	20	68（55，74）	66（54，78）	14/6	13/7	-	-	4
Morelli等2005^[13]	15	15	61.5 ± 7.0	62 ± 7	11/4	12/3	24.4 ± 1.6	23.7 ± 2.1	3
黄河等2015^[14]	26	25	66 ± 3	66 ± 5	15/11	15/10	23.7 ± 6.8	24.5 ± 6.9	1
方明星等2014^[15]	18	18	61 ± 7	62 ± 7	14/4	13/5	23.5 ± 2.4	24.1 ± 2.1	3
刁井地等2014^[16]	19	19	-	-	-	-	19.6 ± 5.9	20.3 ± 4.8	1
赵湛元2013^[17]	15	15	-	-	-	-	-	-	1

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