Does levosimendan improve hemodynamics and survival in patients with serious calcium channel blocker overdose?
Levosimendan may be a beneficial adjunctive therapy for stabilizing hemodynamics in severe calcium channel blocker overdose refractory to standard treatments.
In Brief Calcium channel blocker (CCB) overdose is often lethal. Conventional medical treatment includes IV calcium, high doses of catecholamines, insulin, and glucagon. A new inotropic drug, levosimendan, should be considered in severe CCB poisoning. Levosimendan’s pharmacologic features differ from other inotropic drugs. It is a calcium sensitizer and improves contraction without increasing intracytosolic calcium concentration. We describe two patients with serious CCB overdose. Despite intensive medical and mechanical cardiovascular support, both patients remained in shock. Hemodynamics gradually improved after administration of levosimendan. IMPLICATIONS: We describe two patients who survived a serious calcium channel blocker overdose. The calcium sensitizer levosimendan was used to stabilize hemodynamics and has unique potential benefits in this setting.
Varpula et al. (Fri,) studied this question.