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Effects of levosimendan on the outcome of veno-arterial extracorporeal membrane oxygenation: a systematic review and meta-analysis

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Abstract

Objectives

For patients with severe cardiopulmonary failure, such as cardiogenic shock, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is primarily utilized to preserve their life by providing continuous extracorporeal respiration and circulation. However, because of the complexity of patients’ underlying diseases and serious complications, successful weaning from ECMO is often difficult. At present, there have been limited studies on ECMO weaning strategies, so the principal purpose of this meta-analysis is to examine how levosimendan contributes to the weaning of extracorporeal membrane oxygenation.

Methods

The Cochrane Library, Embase, Web of Science, and PubMed were browsed for all potentially related research about clinical benefits of levosimendan in weaning patients receiving VA-ECMO and included 15 of them. The main outcome is success of weaning from extracorporeal membrane oxygenation, with the secondary outcomes of 1-month mortality (28 or 30 days), ECMO duration, hospital or intensive care unit (ICU) length of stay, and use of vasoactive drugs.

Results

1772 patients altogether from 15 publications were incorporated in our meta-analysis. We used fixed and random-effect models to combine odds ratio (OR) and 95% confidence interval (CI) for dichotomous outcomes and standardized mean difference (SMD) for continuous outcomes. The weaning success rate in the levosimendan group was considerably higher in contrast to the comparison (OR = 2.78, 95% CI 1.80–4.30; P < 0.00001; I2 = 65%), and subgroup analysis showed that there was less heterogeneity in patients after cardiac surgery (OR = 2.06, 95% CI, 1.35–3.12; P = 0.0007; I2 = 17%). In addition, the effect of levosimendan on improving weaning success rate was statistically significant only at 0.2 mcg/kg/min (OR = 2.45, 95% CI, 1.11–5.40; P = 0.03; I2 = 38%). At the same time, the 28-day or 30-day proportion of deaths in the sample receiving levosimendan also decreased (OR = 0.47, 95% CI, 0.28–0.79; P = 0.004; I2 = 73%), and the difference was statistically significant. In terms of secondary outcomes, we found that individuals undergoing levosimendan treatment had a longer duration of VA-ECMO support.

Conclusions

In patients receiving VA-ECMO, levosimendan treatment considerably raised the weaning success rate and helped lower mortality. Since most of the evidence comes from retrospective studies, more randomized multicenter trials are required to verify the conclusion.

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Data availability

Available from the corresponding author upon reasonable request.

References

  1. Rao P, Khalpey Z, Smith R, Burkhoff D, Kociol RD (2018) Venoarterial extracorporeal membrane oxygenation for cardiogenic shock and cardiac arrest. Circ Heart Fail 11(9):e004905. https://doi.org/10.1161/circheartfailure.118.004905

    Article  PubMed  Google Scholar 

  2. Ouweneel DM, Schotborgh JV, Limpens J, Sjauw KD, Engström AE, Lagrand WK, Cherpanath TGV, Driessen AHG, de Mol B, Henriques JPS (2016) Extracorporeal life support during cardiac arrest and cardiogenic shock: a systematic review and meta-analysis. Intensive Care Med 42(12):1922–1934. https://doi.org/10.1007/s00134-016-4536-8

    Article  PubMed  PubMed Central  Google Scholar 

  3. Ostadal P, Rokyta R, Karasek J, Kruger A, Vondrakova D, Janotka M, Naar J, Smalcova J, Hubatova M, Hromadka M, Volovar S, Seyfrydova M, Jarkovsky J, Svoboda M, Linhart A, Belohlavek J (2023) Extracorporeal membrane oxygenation in the therapy of cardiogenic shock: results of the ECMO-CS randomized clinical trial. Circulation 147(6):454–464. https://doi.org/10.1161/circulationaha.122.062949

    Article  CAS  PubMed  Google Scholar 

  4. Panchal AR, Bartos JA, Cabañas JG, Donnino MW, Drennan IR, Hirsch KG, Kudenchuk PJ, Kurz MC, Lavonas EJ, Morley PT, O’Neil BJ, Peberdy MA, Rittenberger JC, Rodriguez AJ, Sawyer KN, Berg KM (2020) Part 3: adult basic and advanced life support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 142(2):S366-s468. https://doi.org/10.1161/cir.0000000000000916

    Article  PubMed  Google Scholar 

  5. Munshi L, Walkey A, Goligher E, Pham T, Uleryk EM, Fan E (2019) Venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a systematic review and meta-analysis. Lancet Respir Med 7(2):163–172. https://doi.org/10.1016/s2213-2600(18)30452-1

    Article  PubMed  Google Scholar 

  6. Guglin M, Zucker MJ, Bazan VM, Bozkurt B, El Banayosy A, Estep JD, Gurley J, Nelson K, Malyala R, Panjrath GS, Zwischenberger JB, Pinney SP (2019) Venoarterial ECMO for adults: JACC scientific expert panel. J Am Coll Cardiol 73(6):698–716. https://doi.org/10.1016/j.jacc.2018.11.038

    Article  PubMed  Google Scholar 

  7. Tsangaris A, Alexy T, Kalra R, Kosmopoulos M, Elliott A, Bartos JA, Yannopoulos D (2021) Overview of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support for the management of cardiogenic shock. Front Cardiovasc Med 8:686558. https://doi.org/10.3389/fcvm.2021.686558

    Article  PubMed  PubMed Central  Google Scholar 

  8. Smith M, Vukomanovic A, Brodie D, Thiagarajan R, Rycus P, Buscher H (2017) Duration of veno-arterial extracorporeal life support (VA ECMO) and outcome: an analysis of the extracorporeal life support organization (ELSO) registry. Crit Care 21(1):45. https://doi.org/10.1186/s13054-017-1633-1

    Article  PubMed  PubMed Central  Google Scholar 

  9. Toller WG, Stranz C (2006) Levosimendan, a new inotropic and vasodilator agent. Anesthesiology 104(3):556–569. https://doi.org/10.1097/00000542-200603000-00024

    Article  CAS  PubMed  Google Scholar 

  10. Yokoshiki H, Katsube Y, Sunagawa M, Sperelakis N (1997) Levosimendan, a novel Ca2+ sensitizer, activates the glibenclamide-sensitive K+ channel in rat arterial myocytes. Eur J Pharmacol 333(2–3):249–259. https://doi.org/10.1016/s0014-2999(97)01108-4

    Article  CAS  Google Scholar 

  11. Kaddoura R, Omar AS, Ibrahim MIM, Alkhulaifi A, Lorusso R, Elsherbini H, Soliman O, Caliskan K (2021) The effectiveness of levosimendan on veno-arterial extracorporeal membrane oxygenation management and outcome: a systematic review and meta-analysis. J Cardiothorac Vasc Anesth 35(8):2483–2495. https://doi.org/10.1053/j.jvca.2021.01.019

    Article  CAS  PubMed  Google Scholar 

  12. Kivikko M, Antila S, Eha J, Lehtonen L, Pentikäinen PJ (2002) Pharmacokinetics of levosimendan and its metabolites during and after a 24-hour continuous infusion in patients with severe heart failure. Int J Clin Pharmacol Ther 40(10):465–471. https://doi.org/10.5414/cpp40465

    Article  CAS  PubMed  Google Scholar 

  13. Ellouze O, Soudry Faure A, Radhouani M, Abou-Arab O, Besnier E, Moussa M, Cransac A, Ksiazek E, Fischer MO, Mertes PM, Bouhemad B, Guinot PG (2021) Levosimendan in venoarterial ECMO weaning rational and design of a randomized double blind multicentre trial. ESC Heart Fail 8(4):3339–3347. https://doi.org/10.1002/ehf2.13427

    Article  PubMed  PubMed Central  Google Scholar 

  14. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:71. https://doi.org/10.1136/bmj.n71

    Article  Google Scholar 

  15. Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, Cates CJ, Cheng HY, Corbett MS, Eldridge SM, Emberson JR, Hernán MA, Hopewell S, Hróbjartsson A, Junqueira DR, Jüni P, Kirkham JJ, Lasserson T, Li T, McAleenan A, Reeves BC, Shepperd S, Shrier I, Stewart LA, Tilling K, White IR, Whiting PF, Higgins JPT (2019) RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 366:l4898. https://doi.org/10.1136/bmj.l4898

    Article  PubMed  Google Scholar 

  16. McCarthy FH, McDermott KM, Kini V, Gutsche JT, Wald JW, Xie D, Szeto WY, Bermudez CA, Atluri P, Acker MA, Desai ND (2015) Trends in US extracorporeal membrane oxygenation use and outcomes: 2002–2012. Semin Thorac Cardiovasc Surg 27(2):81–88. https://doi.org/10.1053/j.semtcvs.2015.07.005

    Article  PubMed  PubMed Central  Google Scholar 

  17. Stub D, Bernard S, Pellegrino V, Smith K, Walker T, Sheldrake J, Hockings L, Shaw J, Duffy SJ, Burrell A, Cameron P (2015) Refractory cardiac arrest treated with mechanical CPR, hypothermia, ECMO and early reperfusion (the CHEER trial). Resuscitation 86:88–94. https://doi.org/10.1016/j.resuscitation.2014.09.010

    Article  PubMed  Google Scholar 

  18. Distelmaier K, Roth C, Schrutka L, Binder C, Steinlechner B, Heinz G, Lang IM, Maurer G, Koinig H, Niessner A et al (2016) Beneficial effects of levosimendan on survival in patients undergoing extracorporeal membrane oxygenation after cardiovascular surgery. Br J Anaesth 117(1):52–58. https://doi.org/10.1093/bja/aew151

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Guilherme E, Jacquet-Lagreze M, Pozzi M, Achana F, Armoiry X, Fellahi J-L (2020) Can levosimendan reduce ECMO weaning failure in cardiogenic shock?: a cohort study with propensity score analysis. Crit Care 24(1):2. https://doi.org/10.1186/s13054-020-03122-y

    Article  Google Scholar 

  20. Jacky A, Rudiger A, Kruger B, Wilhelm MJ, Paal S, Seifert B, Spahn DR, Bettex D (2018) Comparison of levosimendan and milrinone for ECLS weaning in patients after cardiac surgery-a retrospective before-and-after study. J Cardiothorac Vasc Anesth 32(5):2112–2119. https://doi.org/10.1053/j.jvca.2018.04.019

    Article  CAS  PubMed  Google Scholar 

  21. Sangalli F, Avalli L, Laratta M, Formica F, Maggioni E, Caruso R, Costa MC, Guazzi M, Fumagalli R (2016) Effects of levosimendan on endothelial function and hemodynamics during weaning from veno-arterial extracorporeal life support. J Cardiothorac Vasc Anesth 30(6):1449–1453. https://doi.org/10.1053/j.jvca.2016.03.139

    Article  CAS  PubMed  Google Scholar 

  22. Deschka H, Schafers B, Gottschalk A, Scherer M, Martens S, Welp H (2019) Effects of levosimendan therapy in patients undergoing extracorporeal membrane oxygenation after cardiac surgery. Thorac Cardiovasc Surg 67:2. https://doi.org/10.1055/s-0039-1679012

    Article  Google Scholar 

  23. Vally S, Ferdynus C, Persichini R, Bouchet B, Braunberger E, Lo Pinto H, Martinet O, Vandroux D, Aujoulat T, Allyn J, Allou N (2019) Impact of levosimendan on weaning from peripheral venoarterial extracorporeal membrane oxygenation in intensive care unit. Ann Intens Care. 9(1):2. https://doi.org/10.1186/s13613-019-0503-1

    Article  CAS  Google Scholar 

  24. Ng WS, Tang KB, Shum HP (2022) Impact of levosimendan use on survival of patients on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support. Crit Care 26(1):2. https://doi.org/10.1186/s13054-022-03927-z

    Article  Google Scholar 

  25. Zipfel S, Reiter B, Sill B, Barten M, Rybczinski M, Kubik M, Kluge S, Reichenspurner H, Bernhardt A (2018) Levosimendan effects benefit weaning from veno-arterial extracorporeal life support. Thoracic and cardiovascular surgeon. Conference: 47th annual meeting of the german society for thoracic and cardiovascular surgery, DGTHG 2018. Germany, 2018. 66(Supplement 1) (no pagination). https://doi.org/10.1055/s-0038-1628090

  26. Haffner G, Ajob G, Cristinar M, Marguerite S, Oulehri W, Heger B, Kindo M, Mertes PM, Steib A (2018) Levosimendan for weaning veno-arterial ECMO (VA ECMO). Crit Care 22:2. https://doi.org/10.1186/s13054-018-1973-5

    Article  Google Scholar 

  27. Alonso-Fernandez-Gatta M, Merchan-Gomez S, Gonzalez-Cebrian M, Diego-Nieto A, Alzola E, Toranzo-Nieto I, Barrio A, Martin-Herrero F, Sanchez PL (2021) Levosimendan in veno-arterial extracorporeal membrane oxygenator supported patients: Impact on the success of weaning and survival. Artif Organs 45(7):717–725. https://doi.org/10.1111/aor.13899

    Article  CAS  PubMed  Google Scholar 

  28. Affronti A, Di Bella I, Carino D, Ragni T (2013) Levosimendan may improve weaning outcomesin venoarterial ECMO patients. ASAIO J 59(6):554–557. https://doi.org/10.1097/MAT.0b013e3182a4b32e

    Article  PubMed  Google Scholar 

  29. Hau M, Fong KM, Au SY (2022) Levosimendan’s effect on venoarterial extracorporeal membrane oxygenation weaning. Int J Artif Organs. https://doi.org/10.1177/03913988221098773

    Article  PubMed  Google Scholar 

  30. Florchinger B, Provaznik Z, Philipp A, Foltan M, Camboni D, Rupprecht L, Lunz D, Schmid C (2021) Use of levosimendan in adult patients with postcardiotomy extracorporeal life support: a single-center experience. Thorac Cardiovasc Surg 69(1):2. https://doi.org/10.1055/s-0041-1725792

    Article  Google Scholar 

  31. Chen Y-W, Lee W-C, Wu P-J, Fang H-Y, Fang Y-N, Chen H-C, Tong M-S, Sung P-H, Lee C-H, Chung W-J (2022) Early levosimendan administration improved weaning success rate in extracorporeal membrane oxygenation in patients with cardiogenic shock. Front Cardiovasc Med 9:2. https://doi.org/10.3389/fcvm.2022.912321

    Article  ADS  CAS  Google Scholar 

  32. Gaisendrees C, Gerfer S, Ivanov B, Sabashnikov A, Eghbalzadeh K, Djordjevic I, Wahlers T (2022) Feasibility and safety of levosimendan in patients after cardiac arrest treated with eCPR. Perfusion 37(1 SUPPL):4. https://doi.org/10.1177/02676591221089240

    Article  Google Scholar 

  33. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GMC, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P (2016) 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European society of cardiology (ESC)developed with the special contribution of the heart failure association (HFA) of the ESC. Eur Heart J 37(27):2129–2200. https://doi.org/10.1093/eurheartj/ehw128

    Article  PubMed  Google Scholar 

  34. Werdan K, Ruß M, Buerke M, Delle-Karth G, Geppert A, Schöndube FA (2012) Cardiogenic shock due to myocardial infarction: diagnosis, monitoring and treatment: a German–Austrian S3 guideline. Dtsch Arztebl Int 109(19):343–351. https://doi.org/10.3238/arztebl.2012.0343

    Article  PubMed  PubMed Central  Google Scholar 

  35. Qiu J, Jia L, Hao Y, Huang S, Ma Y, Li X, Wang M, Mao Y (2017) Efficacy and safety of levosimendan in patients with acute right heart failure: a meta-analysis. Life Sci 184:30–36. https://doi.org/10.1016/j.lfs.2017.07.001

    Article  CAS  PubMed  Google Scholar 

  36. Fedele F, Bruno N, Brasolin B, Caira C, D’Ambrosi A, Mancone M (2014) Levosimendan improves renal function in acute decompensated heart failure: possible underlying mechanisms. Eur J Heart Fail 16(3):281–288. https://doi.org/10.1002/ejhf.9

    Article  CAS  PubMed  Google Scholar 

  37. Nieminen MS, Altenberger J, Ben-Gal T, Böhmer A, Comin-Colet J, Dickstein K, Edes I, Fedele F, Fonseca C, García-González MJ, Giannakoulas G, Iakobishvili Z, Jääskeläinen P, Karavidas A, Kettner J, Kivikko M, Lund LH, Matskeplishvili ST, Metra M, Morandi F, Oliva F, Parkhomenko A, Parissis J, Pollesello P, Pölzl G, Schwinger RH, Segovia J, Seidel M, Vrtovec B, Wikström G (2014) Repetitive use of levosimendan for treatment of chronic advanced heart failure: clinical evidence, practical considerations, and perspectives: an expert panel consensus. Int J Cardiol 174(2):360–367. https://doi.org/10.1016/j.ijcard.2014.04.111

    Article  CAS  PubMed  Google Scholar 

  38. Vallabhajosyula S, Dunlay SM, Prasad A, Kashani K, Sakhuja A, Gersh BJ, Jaffe AS, Holmes DR Jr, Barsness GW (2019) Acute noncardiac organ failure in acute myocardial infarction with cardiogenic shock. J Am Coll Cardiol 73(14):1781–1791. https://doi.org/10.1016/j.jacc.2019.01.053

    Article  PubMed  Google Scholar 

  39. Cholley B, Levy B, Fellahi JL, Longrois D, Amour J, Ouattara A, Mebazaa A (2019) Levosimendan in the light of the results of the recent randomized controlled trials: an expert opinion paper. Crit Care 23(1):385. https://doi.org/10.1186/s13054-019-2674-4

    Article  PubMed  PubMed Central  Google Scholar 

  40. Avgeropoulou C, Andreadou I, Markantonis-Kyroudis S, Demopoulou M, Missovoulos P, Androulakis A, Kallikazaros I (2005) The Ca2+-sensitizer levosimendan improves oxidative damage, BNP and pro-inflammatory cytokine levels in patients with advanced decompensated heart failure in comparison to dobutamine. Eur J Heart Fail 7(5):882–887. https://doi.org/10.1016/j.ejheart.2005.02.002

    Article  CAS  PubMed  Google Scholar 

  41. Guilherme E, Jacquet-Lagrèze M, Pozzi M, Achana F, Armoiry X, Fellahi JL (2020) Can levosimendan reduce ECMO weaning failure in cardiogenic shock?: a cohort study with propensity score analysis. Crit Care 24(1):442. https://doi.org/10.1186/s13054-020-03122-y

    Article  PubMed  PubMed Central  Google Scholar 

  42. Hau M, Fong KM, Au SY (2022) Levosimendan’s effect on venoarterial extracorporeal membrane oxygenation weaning. Int J Artif Organs. https://doi.org/10.1177/03913988221098773

    Article  PubMed  Google Scholar 

  43. Landoni G, Biondi-Zoccai G, Greco M, Greco T, Bignami E, Morelli A, Guarracino F, Zangrillo A (2012) Effects of levosimendan on mortality and hospitalization. A meta-analysis of randomized controlled studies. Crit Care Med 40(2):634–646. https://doi.org/10.1097/CCM.0b013e318232962a

    Article  CAS  PubMed  Google Scholar 

  44. Follath F, Cleland JG, Just H, Papp JG, Scholz H, Peuhkurinen K, Harjola VP, Mitrovic V, Abdalla M, Sandell EP, Lehtonen L (2002) Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low-output heart failure (the LIDO study): a randomised double-blind trial. Lancet 360(9328):196–202. https://doi.org/10.1016/s0140-6736(02)09455-2

    Article  CAS  PubMed  Google Scholar 

  45. Feng F, Chen Y, Li M, Yuan JJ, Chang XN, Dong CM (2019) Levosimendan does not reduce the mortality of critically ill adult patients with sepsis and septic shock: a meta-analysis. Chin Med J (Engl) 132(10):1212–1217. https://doi.org/10.1097/cm9.0000000000000197

    Article  CAS  PubMed  Google Scholar 

  46. Van De Moortel L, De Mey N, De Decker K (2020) Levosimendan after cardiac surgery: a single-center case series. Chest 157(6):A137. https://doi.org/10.1016/j.chest.2020.05.155

    Article  Google Scholar 

  47. Cholley B, Levy B, Fellahi JL, Longrois D, Amour J, Ouattara A, Mebazaa A (2019) Levosimendan in the light of the results of the recent randomized controlled trials: an expert opinion paper. Crit Care 23(1):2. https://doi.org/10.1186/s13054-019-2674-4

    Article  Google Scholar 

  48. Schrage B, Becher PM, Bernhardt A, Bezerra H, Blankenberg S, Brunner S, Colson P, CudemusDeseda G, Dabboura S, Eckner D, Eden M, Eitel I, Frank D, Frey N, Funamoto M, Goßling A, Graf T, Hagl C, Kirchhof P, Kupka D, Landmesser U, Lipinski J, Lopes M, Majunke N, Maniuc O, McGrath D, Möbius-Winkler S, Morrow DA, Mourad M, Noel C, Nordbeck P, Orban M, Pappalardo F, Patel SM, Pauschinger M, Pazzanese V, Reichenspurner H, Sandri M, Schulze PC (2020) Left Ventricular Unloading Is Associated With Lower Mortality in Patients With Cardiogenic Shock Treated With Venoarterial Extracorporeal Membrane Oxygenation: Results From an International Multicenter Cohort Study. Circulation 142(22):2095–2106. https://doi.org/10.1161/circulationaha.120.048792

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Ahmad S, Ahsan MJ, Ikram S, Lateef N, Khan BA, Tabassum S, Naeem A, Qavi AH, Ardhanari S, Goldsweig AM (2023) Impella versus extracorporeal membranous oxygenation (ecmo) for cardiogenic shock: a systematic review and meta-analysis. Curr Probl Cardiol 48(1):101427. https://doi.org/10.1016/j.cpcardiol.2022.101427

    Article  PubMed  Google Scholar 

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Acknowledgements

We wish to thank our colleagues from the Department of Critical Care Medicine, Qilu Hospital of Shandong University for their valuable comments on the manuscript.

Funding

This work was supported by grants from the National Natural Science Foundation of China (82172165), Taishan Young Scholar Program of Shandong Province (tsqn202103171), Clinical Research Foundation of Shandong Province Medical Association (YXH2020ZX024), and project of China International Medical Foundation (2022N0113). The project is funded by China Postdoctoral Science Foundation (2020T130072ZX) and Clinical Research Center of Shandong University (2020SDUCRCC007).

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  1. Yuliang Liu, Lichen Zhang and Yong Yao contributed equally to this work.

Authors and Affiliations

  1. Department of Critical Care Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, China

    Yuliang Liu, Lichen Zhang, Yong Yao, Yihui Li, Weidong Qin, Yuan Li, Wanlin Xue, Pengyong Li, Xiaomei Chen & Haipeng Guo

  2. The Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China

    Yuliang Liu, Lichen Zhang, Yong Yao, Yihui Li, Weidong Qin, Yuan Li, Wanlin Xue, Pengyong Li, Yuguo Chen, Xiaomei Chen & Haipeng Guo

  3. The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China

    Yuliang Liu, Lichen Zhang, Yong Yao, Yihui Li, Weidong Qin, Yuan Li, Wanlin Xue, Pengyong Li, Yuguo Chen, Xiaomei Chen & Haipeng Guo

  4. Department of Emergency Medicine and Chest Pain Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China

    Yuguo Chen

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Contributions

YL, HG, YC, and XC are jointly responsible for designing the study. YL, LZ, and YY participated in writing the paper. WQ, YL, and YL took part in carrying out the study. WX and PL worked on analyzing the data. All the authors approved the final manuscript and are responsible for the content.

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Correspondence to Xiaomei Chen or Haipeng Guo.

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Liu, Y., Zhang, L., Yao, Y. et al. Effects of levosimendan on the outcome of veno-arterial extracorporeal membrane oxygenation: a systematic review and meta-analysis. Clin Res Cardiol 113, 509–521 (2024). https://doi.org/10.1007/s00392-023-02208-1

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