The Use of Levosimendan in Infants With Heart Disease: A Scoping Review

BACKGROUND: Although levosimendan is a promising and innovative inotrope for adults with heart disease, limited research has been conducted to demonstrate its safety and efficacy in infants. PURPOSE: This scoping review evaluates the current state of literature regarding the use of levosimendan in infants with heart disease. DATA SOURCES: A comprehensive literature search was conducted across PubMed, Cinahl, Embase, and Scopus databases for studies published between January 2016 and February 2025. STUDY SELECTION: Inclusion criteria included primary research studies involving the neonatal/infant population, evaluation of levosimendan therapy, written in English, and published within the last decade. Studies that primarily examined older pediatric or adult populations were excluded. Initial database searches yielded 310 articles. Duplicates were removed and titles, and abstracts were screened. Fourteen articles met the full-text review criteria. DATA EXTRACTION: The author independently extracted data to map the scope of available evidence, with a focus on understanding findings related to levosimendan therapy in the target population. RESULTS: Levosimendan was associated with improvements in lactate levels, central venous oxygen saturation, and left ventricular function. Despite these benefits, cardiac outcomes were inconsistent across studies. Safety profiles were favorable, with rare but manageable adverse events such as arrhythmias and hypotension. IMPLICATIONS FOR PRACTICE AND RESEARCH: Large, multicenter, randomized, controlled trials with standardized protocols are needed to evaluate the effectiveness of levosimendan in neonatal/infant populations. Nurses are essential in promoting ethical, patient-centered, and evidence-based clinical research and care for this vulnerable population.