Conclusion
postcardiotomy cardiogenic shock
Our study did not find an association of levosimendan administration and VA-ECMO-weaning or mortality in patients with refractory postcardiotomy cardiogenic shock. These results issued from one of the largest cohorts studied to date and the only one using the emulated target trial approach might cast some doubt on the efficacy of levosimendan. The comparison with the results of an ongoing interventional study (LEVOECMO trial, NCT04728932) for the same clinical question may help to resolve the current discrepancies in observational data.