ABSTRACT
Objective To investigate the clinical effect of levosimendan in perioperative aortic and/or mitral valvereplacement. Methods Patients undergoing open heart aortic and/or mitral valve replacement in our hospitalfrom January 2018 to December 2019 were enrolled. 45 patients in the control group received routineperioperative treatment based on dopamine, while 45 patients in the research group received continuousperioperative administration of levosimendan injection for 24h on the basis of routine treatment. The leftventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVDd) and left ventricular end-systolicdiameter (LVDs) were evaluated by color doppler echocardiography before and one week after surgery.Postoperative mechanical ventilation weaning time, length of ICU stays, number of vasoactive drugs used andwithdrawal time; indexes of liver and kidney function before and on the day after surgery to 10 days after surgery;use of in vitro support techniques such as aortic balloon pulsation (IABP), continuous renal replacement therapy(CRRT) and extracorporeal membrane oxygenation (ECMO) within 5 days of perioperative period. Results Theimprovement of LVDs and LVEF in the study group using levosimendan one week after the operation wassignificantly better than that in the control group (P value was 0.013 and 0.001, respectively), and fewer kinds ofvasoactive drugs were needed (P<0.001), and the risk of postoperative AKI in the study group was significantlylower than that in the control group (P=0.047). Conclusion The perioperative use of levosimendan can effectivelypromote the recovery of cardiac systolic function and reduce the risk of postoperative AKI.
ABSTRACT
The purpose of this study is to find out whether there are broad cross-reactivity between antibacterial and nonantibacterial sulfonamide agents, the method of the study contained two parts, one is literature research mainlyfrom PubMed database by using the MeSH terms (“Drug name” + allergy); (“Drug name” + hypersensitivity);(“Drug name” + cross-allergenicity) and (“Drug name + cross-reactivity), the search drugs included somecommonly seen medication such as carbonic anhydrase inhibitor, COX-2 inhibitor, loop diuretic, sulfonylurea,thiazide and certain antiviral drugs; the other parts of this thesis is to conduct a statistical review, we screen outpatients who have a previous allergic history of antimicrobial sulfonamides from hospital medical record systemduring Jan 1st, 2015 to Dec 31th, 2016, we did a descriptive statistics of general patients medical information,analyze the suspect cases which patients present potential allergic reaction after using non-antimicrobialsulfonamides agents. Result of literature research reveal there are no convincing evidences and research toconfirm there are bored allergenicity between non-antimicrobial sulfonamides and antimicrobial sulfonamide inthe aspects of chemical structure, immunological study, and large scale population study as well; Result ofhospital patient’s statistics found out there are only 3 suspected cases that the patients were having adverseeffect during their pharmacotherapy from 506 cases. However, we did not found any strong correlation of broadallergenicity between non-antimicrobial sulfonamides and antimicrobial sulfonamides from these suspectedcases. Conclusion: There is minimal evidence of cross-reactivity between the antimicrobial sulfonamides and thenon-antimicrobial sulfonamides. However, the non-antimicrobial sulfonamides are rarely implicated inhypersensitivity reactions as well, so it is impossible to say with certainty that cross-reactivity does not occur.