nEffect of levosimendan treatment in pediatric patients with cardiac dysfunction: an update of a systematic review and meta-analysis of randomized controlled trials

Abstract Objective Levosimendan has been increasingly used to treat heart failure and cardiac dysfunction in pediatric patients. Currently, there is only limited evidence that this drug positively affects outcome. Our aim was to investigate the effects of levosimendan on hemodynamic parameters and outcome in pediatric patients in all clinical settings. Design Systematic review of randomized and non-randomized studies. Randomized clinical trials were included in a meta-analysis. The primary outcome of the metaanalysis was the effect of levosimendan on central venous oxygen saturation (ScvO 2) and lactate values as surrogate markers of low cardiac output syndrome. Setting Any acute care setting Participants: Pediatric patients (age Conclusion Levosimendan use in pediatric patients is not associated with major side effects and may lead to hemodynamic improvement after cardiac surgery. However, its impact on major clinical outcomes remains to be determined. Overall, the quality of evidence for levosimendan use in pediatric patients is low, and further high-quality RCTs are needed.