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.

• MeSH
• jednotky intenzivní péče * MeSH
• kardiogenní šok diagnóza   farmakoterapie   mortalita   patofyziologie   MeSH
• kardiorenální syndrom diagnóza   farmakoterapie   mortalita   patofyziologie   MeSH
• kardiotonika škodlivé účinky   terapeutické užití   MeSH
• lidé MeSH
• obnova funkce MeSH
• péče o pacienty v kritickém stavu MeSH
• rizikové faktory MeSH
• septický šok diagnóza   farmakoterapie   mortalita   patofyziologie   MeSH
• simendan škodlivé účinky   terapeutické užití   MeSH
• vazodilatancia škodlivé účinky   terapeutické užití   MeSH
• výsledek terapie MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH