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SHR Neuro Cancer Cardio Lipid Metab Microb

Heringlake, M; Alvarez, J; Bettex, D; Bouchez, S; Fruhwald, S; Girardis, M; Grossini, E; Guarracino, F; Herpain, A; Toller, W; Tritapepe, L; Pollesello, P.
An update on levosimendan in acute cardiac care: applications and recommendations for optimal efficacy and safety.
EXPERT REV CARDIOVAS. 2021; 19(4): 325-335. Doi: 10.1080/14779072.2021.1905520 [OPEN ACCESS]
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Co-authors Med Uni Graz

Fruhwald Sonja

Toller Wolfgang

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Abstract:

Introduction: In the 20 years since its introduction to the palette of intravenous hemodynamic therapies, the inodilator levosimendan has established itself as a valuable asset for the management of acute decompensated heart failure. Its pharmacology is notable for delivering inotropy via calcium sensitization without an increase in myocardial oxygen consumption.Areas covered: Experience with levosimendan has led to its applications expanding into perioperative hemodynamic support and various critical care settings, as well as an array of situations associated with acutely decompensated heart failure, such as right ventricular failure, cardiogenic shock with multi-organ dysfunction, and cardio-renal syndrome. Evidence suggests that levosimendan may be preferable to milrinone for patients in cardiogenic shock after cardiac surgery or for weaning from extracorporeal life support and may be superior to dobutamine in terms of short-term survival, especially in patients on beta-blockers. Positive effects on kidney function have been noted, further differentiating levosimendan from catecholamines and phosphodiesterase inhibitors.Expert opinion:Levosimendan can be a valuable resource in the treatment of acute cardiac dysfunction, especially in the presence of beta-blockers or ischemic cardiomyopathy. When attention is given to avoiding or correcting hypovolemia and hypokalemia, an early use of the drug in the treatment algorithm is preferred.

Find related publications in this database (using NLM MeSH Indexing)

Adrenergic beta-Antagonists - therapeutic use

Cardiac Surgical Procedures -

Cardiotonic Agents - therapeutic use

Critical Care -

Dobutamine - administration & dosage

Heart Failure - drug therapy

Heart Failure - physiopathology

Hemodynamics - drug effects

Humans -

Shock, Cardiogenic - drug therapy

Simendan - therapeutic use

Find related publications in this database (Keywords)

Critical care

calcium sensitization

adenosine triphosphate-sensitive potassium (K-ATP) channels

mitochondria

levosimendan

cardiogenic shock

acute heart failure

low cardiac output syndrome

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