Outcomes
death, ECMO failure
SECONDARY, BIVENTRICULAR FAILURE
Regarding the time to successful ECMO weaning, no statistically significant association with levosimendan treatment was found in univariable analysis (cause-specific hazard ratio HR = 1.34, 95% confidence interval CI95 [0.92; 1.96], Cumulative incidences of ECMO weaning success in the presence of competing risks of death and ECMO weaning failure after ECMO removal. The cumulative incidence curves of ECMO weaning success were plotted with the Gray’s estimator that accounts for the competing risk of death and the competing risk of ECMO failure after ECMO removal [Subgroup analyses according to the timing of ECMO implantation, timing of treatment assignment (levosimendan received in the first three days of ECMO or after), single or biventricular failure, ECMO implantation timing (in the operating room or in the ICU), indication for surgery, and RRT showed no significant difference between patients receiving levosimendan or not (Table Subgroups analyses for the effect of levosimendan on ECMO weaning success: multivariable Cox modelCI95, 95% confidence interval; ECMO, extracorporeal membrane oxygenation; HR, hazard ratio; ICU; intensive care unit; OR; operating room; RRT: renal replacement therapy at baseline of the nested trial. Robust variances were estimated by bootstrap (1000 iterations)For the secondary outcomes, there was no significant association of levosimendan and 30-day mortality in univariable (OR = 0.60, CI95 [0.35; 1.03], 