Cardiovascular effects of levosimendan during rewarming from severe hypothermia in vivo

Rewarming from hypothermia is often complicated by rewarming shock characterized by decreased cardiac output (CO) and a fall in arterial pressure. Here we tested whether levosimendan, a calcium sensitizer, improves hemodynamics after rewarming from experimental hypothermia. Methods A rat model designed to monitor left ventricular (LV) cardiac function (Millar conductance catheter), and femoral artery pressure during experimental hypothermia (4h at 15°C) and rewarming was used. A control group received levosimendan‐placebo i.v the last hour of hypothermia and during rewarming. The intervention group received levosimendan using the same protocol. Results After rewarming to 37°C the measurements showed a reduction in myocardial depression in the intervention group. CO, stroke volume and the cardiac contractility were significantly depressed in the control group, while they returned to baseline values in the intervention group. Compared to baseline conditions, CO was decreased by 59.1% ±4.6 in the control group after hypothermia/rewarming (H/R) while CO increased by 1.1% ±14.39 after H/R in the intervention group (p<0.05). Conclusion Our data indicates that levosimendan improves myocardial dysfunction associated to H/R by improving CO, SV, and PRSW. The use of calcium sensitizers in the clinical setting require further investigation.