Safety and effectiveness of levosimendan administration without loading dose in a specialized heart failure unit

Abstract

Objective: to evaluate the safety and effectiveness of levosimendan administration in patients with chronic heart failure, signs of low output, and indications for inotropic therapy. The protocol included a continuous infusion of levosimendan without loading dose, with a total dosage of 12.5 miligrams.

Methods: a retrospective, descriptive study was performed to evaluate changes in mean arterial pressure, the development of arrhythmias, adverse effects like death during the infusion, and functional changes in the two months after the treatment.

Results: the infusion was well tolerated, without side effects. Mean arterial pressure before the infusion was 71± 21.6 vs. 75 ± 20.9 mmHg 24 hours after and 71 ± 21.6 vs. 71.6 ± 21.4 48 hours after. There was one death (4.7%), explained by non-cardiovascular causes (sepsis). An improvement in functional class was observed during the follow-up.

Conclusion: this report of an initial experience suggests that the administration of levosimendan infusion without loading dose is safe and can be used outside the intensive care unit