title: Levosimendan in critical illness: a literature review.
abstract: Levosimendan, the active enantiomer of simendan, is a calcium sensitizer developed for treatment of decompensated heart failure, exerts its effects independently of the beta adrenergic receptor and seems beneficial in cases of severe, intractable heart failure. Levosimendan is usually administered as 24-h infusion, with or without a loading dose, but dosing needs adjustment in patients with severe liver or renal dysfunction. Despite several promising reports, the role of levosimendan in critical illness has not been thoroughly evaluated. Available evidence suggests that levosimendan is a safe treatment option in critically ill patients and may reduce mortality from cardiac failure. However, data from well-designed randomized controlled trials in critically ill patients are needed to validate or refute these preliminary conclusions. This literature review is an attempt to synthesize available evidence on the role and possible benefits of levosimendan in critically ill patients with severe heart failure.
authors.affiliation: Department of Intensive Care, Universite Catholique de Louvain, Mont-Godinne University Hospital, Yvoir 5530, Belgium.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Pierrakos
authors.affiliation: Department of Internal Medicine, University of Patras School of Medicine, Patras, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Velissaris
authors.affiliation: Department of Medical Biotechnologies, University of Siena, Siena, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Franchi
authors.affiliation: Department of Medical Biotechnologies, University of Siena, Siena, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Muzzi
authors.affiliation: Department of Anesthesiology, Washington University School of Medicine, Campus Box 8054, 660 S. Euclid Avenue, St. Louis, MO, USA.
authors.forename: Menelaos
authors.initials: M
authors.lastname: Karanikolas
authors.affiliation: Department of Medical Biotechnologies, University of Siena, Siena, Italy.
authors.forename: Sabino
authors.initials: S
authors.lastname: Scolletta
keywords: Cardiogenic shock; Coronary artery surgery; Critical care; Diastolic dysfunction; Heart failure; Intensive care; Levosimendan; Liver failure; Myocardial infarction; Renal failure; Sepsis; Septic shock; Shock; Valve surgery