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Levosimendan.

Asher Levin¹, Gideon Paret¹

¹Department of Pediatric Intensive Care Unit, Edmond and Lily Safra Children's Hospital, The Chaim Sheba medical center, Tel Hashomer, affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

Journal of Pediatric Intensive Care

|June 20, 2019

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Levosimendan enhances heart contractility and vasodilation by increasing calcium sensitivity. This inodilator is effective for critically ill adults and children with severe heart failure and in specific pediatric cardiac conditions.

Area of Science:

Cardiology
Pharmacology
Critical Care Medicine

Background:

Severe congestive heart failure (CHF) in adults and children often requires inotropic support.
Acutely decompensated heart failure presents significant clinical challenges.
Levosimendan is an inodilator with a unique mechanism of action.

Purpose of the Study:

To review the mechanism of action of levosimendan.
To examine the clinical application of levosimendan in critically ill patients.
To assess levosimendan's efficacy in both adult and pediatric populations with severe heart failure.

Main Methods:

Systematic review of English-language literature.
Searches conducted using PubMed and Google.
Inclusion of studies on general populations and pediatric cohorts (0-18 years).

Keywords:

Levosimendan acutely ill children cardiac surgery cost efficiency inotropic therapy low cardiac output syndrome mechanical circulatory support

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Main Results:

Levosimendan increases cardiac contractility via calcium-dependent troponin C binding.
It induces vasodilation by opening ATP-sensitive potassium channels.
Demonstrated efficacy in acute decompensated heart failure, septic shock, and device weaning.

Conclusions:

Levosimendan is effective for acute decompensated heart failure in critically ill patients.
It shows promise in neonates with hypoplastic left heart syndrome post-surgery.
Further discussion on the cost-effectiveness of levosimendan is warranted.