Pulmonary vascular resistance decreased significantly with both doses of LS, as did coronary artery resistance, the latter being indicative of coronary vasodilation (P < 0.05). Furthermore, an increase in coronary blood flow of 28 ml/min and 42 ml/min with LS, 8 /kg and 24 /kg, respectively, was obtained (P = 0.054 for both doses combined). Despite the markedly improved cardiac function seen with LS, neither dose significantly increased myocardial O2 consumption compared with placebo. In addition, no significant differences in myocardial free fatty acid, lactate, pyruvate and glucose utilisation were observed in LStreated patients compared to placebo controls. In conclusion, based on the results of this study, LS may be of significant benefit in improving cardiac function in patients with low CO following coronary artery bypass surgery, with no significant increase in O2 consumption.P141 Haemodynamic effects of levosimendan in patients during weaning from cardiopulmonary bypassR Demeyere*, P Herijgers, W Flameng *Department of Anaesthesia, and Department of Cardiac Surgery, University Hospital Gasthuisberg, Leuven, Belgium Levosimendan (LS) is a calcium sensitiser indicated for the treatment of acute heart failure that possesses a novel dual mechanism of action. It increases both cardiac contractility and induces coronary and systemic vasodilation. In PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20724077 this study the haemodynamic effects of LS were assessed in nine patients (classified as `high risk’) undergoing combined aortic or mitral valve repair/replacement and multiple coronary artery bypass grafting surgery. Immediately after weaning from cardiopulmonary bypass LS, 24 /kg,Critical CareVol 6 Suppl22nd International Symposium on Intensive Care and Emergency Medicinewas given intravenously over 10 min. Haemodynamic data were recorded for up to 60 min post-infusion using thermodilution, 2-D transoesophageal echocardiography and pressure/volume analysis using a Millar 12 pole-conductance catheter with an integrated pressure sensor. The results (Table 1) show that the LS infusion increased cardiac index (CI), mainly through an increase in stroke index (SI) and a decrease in systemic vascular resistance (SVR). LS treatmentTableimproved left ventricular contractility (+dP/dt) and end-systolic elastance (Ees), MK-1064 without a significant change in the left ventricular isovolumic pressure decline time constant (Tau). LS increased coronary graft flow by 32 (P < 0.05). No arrhythmias occurred during the 60-min study period. In conclusion, a 10-min intravenous infusion of LS significantly improved left ventricular function and contractility without impairing the rate of ventricular relaxation.Haemodynamic parameters (mean ?SD) before and after the administration of levosimendan CI (l/min/m2) Baseline Peak effect 2.6 ?0.5 3.9 ?0.9* SI (ml/m2) 30 ?7 46 ?10* SVR (dyn/s/cm5) 950 ?374 669 ?224* +dP/dt (mmHg/s) 766 ?113 966 ?131* Ees (mmHg/ml) 1.1 ?0.2 1.5 ?0.2* Tau (ms) 42 ?5 39 ?*P < 0.05 compared with baseline; CI, cardiac index; SI, stroke index; SVR, systemic vascular resistance; +dP/dt, measure of left ventricular contractility; Ees, end-systolic elastance; Tau, time constant of isovolumic pressure decayP142 Levosimendan enhances cardiac performance in patients following cardiac surgery and cardiopulmonary bypassE-P Sandell*, N Nijhawan, PS Pagel, DC Warltier *Orion Pharma, Preclinical and Clinical Research and Development, Cardiovascular Projects, Espoo, Finland; Department of Anesthesiology,.