LEVOSIMENDAN to Facilitate Weaning From ECMO in Severe Cardiogenic Shock Patients

Exclusion Criteria

• •1. Age \<18
• •2. Pregnant or lactating women
• •3. Initiation of VA-ECMO \>48 h
• •4. Resuscitation \>30 minutes in the 48 hours before ECMO (cumulative low-flow time). If a low-flow episode occurs before the 48 hours window prior to ECMO, patients must fully recover consciousness to be randomized.
• •5. Irreversible neurological pathology
• •6. End-stage cardiomyopathy with no hope of LV function recovery
• •7. Mechanical complication of myocardial infarction
• •8. Aortic regurgitation \> II
• •9. VA-ECMO for pulmonary embolism
• •10. VA-ECMO for cardiotoxic drug intoxication
• •11. ECMO after left-ventricle assist device implantation
• •12. VA-ECMO in heart transplant patients
• •13. Patient moribund on the day of randomization, SAPS II \>90
• •14. Liver cirrhosis (Child B or C) and other severe hepatic insufficiency
• •15. Chronic renal failure requiring hemodialysis
• •16. Known hypersensitivity to levosimendan
• •17. History of torsades de pointes in the 30 days prior to inclusion
• •18. History of epilepsy
• •19. Individuals under guardianship, or permanently legally incompetent adults
• •20. Participation to another interventional study
• •21. Patient with a weight over 180 kg
• •22. Known hypersensitivity to polyvitamin CERNEVIT®
• •23. In case of hypervitaminosis to any vitamin contained in this formulation,
• •24. In case of severe hypercalcemia, hypercalciuria, treatment, pathology and/or disorders leading to severe hypercalcemia and/or hypercalciuria
• •25. In combination with vitamin A or retinoids