Acute cardiac care & resuscitation
Levosimendan to Facilitate Weaning From ECMO in Patients With Severe Cardiogenic Shock: The LEVOECMO Randomized Clinical Trial
Authors' conclusion
Among patients with severe but potentially reversible cardiogenic shock supported by VA-ECMO, early levosimendan administration did not significantly reduce the time to successful weaning of ECMO compared with placebo.
Study context
- Population
- Adults with acute, severe but potentially reversible cardiogenic shock who started venoarterial extracorporeal membrane oxygenation (VA-ECMO) in the preceding 48 hours
- Participants
- 205 adults
- Comparison
- Levosimendan vs placebo
- Levosimendann = 101
- Placebon = 104reference
- Primary endpoint
- Time to successful ECMO weaning
- Follow-up
- Within 30 days following randomization
Methodological detailsdouble-blind, placebo-controlled, multicentre (11 intensive care units (ICUs) in France)
- Double-blind
- Placebo-controlled
- Multicentre (11 ICUs in France)
Primary result
As reported in the abstract
Successful ECMO weaning · 30 days
Each group vs placeboRisk difference (95% CI)
Levosimendan
0.0%(−12.8% to 12.7%)
Each group vs placeboSubdistribution hazard ratio (95% CI)P value
Levosimendan
1.02(0.74–1.39)
P = 0.92Secondary outcomes
ECMO duration
P = 0.53
ICU length of stay
P = 0.42
| Outcome | Levosimendan | Placebo | Risk difference (95% CI) | P value | |
|---|---|---|---|---|---|
| Mortality · 60 days | 27.7% | 25.0% | 2.7% (−9.0% to 15.3%) | P = 0.78 | |
| −1001020Difference (linear scale) |
Safety
| Outcome | Levosimendan | Placebo | Absolute risk difference (95% CI) | |
|---|---|---|---|---|
| Ventricular arrhythmias | 17.8% | 8.7% | 9.2% (0.4%–18.1%) | |
| −1001020Difference (linear scale) |
Original publication
Levosimendan to Facilitate Weaning From ECMO in Patients With Severe Cardiogenic Shock: The LEVOECMO Randomized Clinical Trial. JAMA. Published 6 January 2026. doi:10.
Summarised from the published abstract; every number is checked against it