Use of Levosimendan in Intensive Care Unit Settings: An Opinion Paper.
J Cardiovasc Pharmacol
; 73(1): 3-14, 2019 01.
Article
in En
| MEDLINE
| ID: mdl-30489437
Levosimendan is an inodilator that promotes cardiac contractility primarily through calcium sensitization of cardiac troponin C and vasodilatation via opening of adenosine triphosphate-sensitive potassium (KATP) channels in vascular smooth muscle cells; the drug also exerts organ-protective effects through a similar effect on mitochondrial KATP channels. This pharmacological profile identifies levosimendan as a drug that may have applications in a wide range of critical illness situations encountered in intensive care unit medicine: hemodynamic support in cardiogenic or septic shock; weaning from mechanical ventilation or from extracorporeal membrane oxygenation; and in the context of cardiorenal syndrome. This review, authored by experts from 9 European countries (Austria, Belgium, Czech republic, Finland, France, Germany, Italy, Sweden, and Switzerland), examines the clinical and experimental data for levosimendan in these situations and concludes that, in most instances, the evidence is encouraging, which is not the case with other cardioactive and vasoactive drugs routinely used in the intensive care unit. The size of the available studies is, however, limited and the data are in need of verification in larger controlled trials. Some proposals are offered for the aims and designs of these additional studies.
Full text:
1
Collection:
01-internacional
Health context:
4_TD
/
6_ODS3_enfermedades_notrasmisibles
Database:
MEDLINE
Main subject:
Shock, Cardiogenic
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Shock, Septic
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Vasodilator Agents
/
Cardiotonic Agents
/
Cardio-Renal Syndrome
/
Simendan
/
Intensive Care Units
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Animals
/
Humans
Language:
En
Journal:
J Cardiovasc Pharmacol
Year:
2019
Document type:
Article