الفهرس 
Low Cardiac Output Syndrome after cardiac surgeryOnly 14 pages are availabe for public view
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Abstract
Low cardiac output syndrome is one of the most serious complications post cardiac surgery and also is one of the most common predisposing factors to AKI in post cardiac surgery.
The incidence of acute kidney injury at presentation of low cardiac output syndrome post cardiac surgery was 40%. Indicating the great impact of LCOS on development of AKI.
There are many risk factors for LCOS post cardiac surgery including advanced age (<65 years), impaired LV function (>50%), recent MI, complex congenital surgery, severe pulmonary hypertension, on-pump coronary artery bypass grafting with long bypass time, emergency surgery, incomplete revascularization, malnutrition, DM and preoperative renal dysfunction.
Management of LCOS is crucial in preventing development of AKI post cardiac surgery. The standard management of LCOS includes the use of inotropic support. However, the range of available inotropic medications was limited and essentially consists of catecholamines (adrenaline and dobutamine) and phosphodiesterase inhibitors. these therapies were supplemented by levosimendan, an inodilator that exerts its action through a calcium sensitizing effect and a phosphodiesterase inhibiting effect. Levosimendan has a nephroprotective effect independent of the inotropic or cardioprotective effect through inducing a preglomerular vasodilation with an increase in both RBF and GFR.
The use of levosimendan in patients who develop post cardiac surgery low cardiac output syndrome (LCOS), decreases the incidence of kidney failure as compared to beta agonists.