On 2016 Oct 09, Preben Berthelsen commented:

Levosimendan for the Prevention of Acute Organ Dysfunction in Sepsis

Gordon AC et al. NEJM 2016.

A foregone conclusion - Levosimendan does not prevent organ dysfunction in sepsis – that is if you wait long enough before administering it.

Successful treatment of sepsis is based on the prompt administration of antibiotics, volume repletion and perhaps surgery.

In this RCT, levosimendan was first deployed a median of 15-16 hours after a diagnosis of sepsis had been established. In my opinion, it is very unlikely that any intervention - delayed for so many hours - will substantially influence the course of sepsis in a meaningful way.

This trial does not inform on a well-timed use of levosimendan in sepsis. Historically, however, single interventions in sepsis have a poor track record.

P.G.Berthelsen MD, MIA, DCAH. Charlottenlund, Denmark

On 2016 Oct 09, Preben Berthelsen commented:

Levosimendan for the Prevention of Acute Organ Dysfunction in Sepsis

Gordon AC et al. NEJM 2016.

A foregone conclusion - Levosimendan does not prevent organ dysfunction in sepsis – that is if you wait long enough before administering it.

Successful treatment of sepsis is based on the prompt administration of antibiotics, volume repletion and perhaps surgery.

In this RCT, levosimendan was first deployed a median of 15-16 hours after a diagnosis of sepsis had been established. In my opinion, it is very unlikely that any intervention - delayed for so many hours - will substantially influence the course of sepsis in a meaningful way.

This trial does not inform on a well-timed use of levosimendan in sepsis. Historically, however, single interventions in sepsis have a poor track record.

P.G.Berthelsen MD, MIA, DCAH. Charlottenlund, Denmark