Abstract
Cardiac dysfunction, with hemodynamic compromise and need for inotropic support, may complicate cardiac surgery as well as general surgery, leading to unfavorable outcomes [1].
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Clinical summary | |||||
|---|---|---|---|---|---|
Drug | Indications | Cautions | Side effects | Dose | Notes |
Levosimendan | Acutely decompensated heart failure Low output syndrome in cardiac surgery Critically ill patients (evidence mostly from above reported settings) Sepsis-related cardiac dysfunction (unconclusive but promising results) Intermittent levosimendan administration in chronic heart failure | Monitor for hypotension and tachycardia Loading dose has been associated with adverse effects and hypotension and should be avoided whenever possible Should be used with caution in patients with renal or hepatic impairment | Hypotension (dose dependant) Tachycardia Headache Atrial/ventricular arrhythmias | [Loading dose: 6–12 μg/kg, see cautions] Continuous infusion of 0.05–0.1 μg/kg/min, if tolerated can be increased up to 0.2 μg/kg/min | Hemodynamic effect persist for at least 24 h, and has been reported to last for 7–10 days No adjustment is required for age Can be used in patients receiving β-blocking agents without loss of efficacy. Synergistic effects with classic inotropes |
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Greco, M., Paternoster, G., Mamo, D. (2017). Levosimendan. In: Landoni, G., Ruggeri, L., Zangrillo, A. (eds) Reducing Mortality in the Perioperative Period. Springer, Cham. https://doi.org/10.1007/978-3-319-46696-5_7
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DOI: https://doi.org/10.1007/978-3-319-46696-5_7
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