{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T04:04:30Z","timestamp":1767067470451,"version":"3.48.0"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009741","name":"David och Astrid Hagel\u00e9ns Stiftelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009741","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007687","name":"Svenska L\u00e4kares\u00e4llskapet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite developments in advanced life support, outcomes after out\u2010of\u2010hospital cardiac arrest (OHCA) remain poor. Levosimendan, a calcium\u2010sensitizing inodilator commonly used in heart failure, has shown beneficial effects in several experimental models and anecdotal clinical cases of cardiac arrest. The Levosimendan in Cardiac Arrest (LeiCA) pilot trial will evaluate levosimendan as an adjunct to advanced life support in refractory OHCA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This will be an investigator\u2010initiated, randomized, double\u2010blind, placebo\u2010controlled, single\u2010center pilot trial. Patients aged 18\u201375\u2009years with witnessed, nontraumatic, refractory OHCA in Stockholm County, Sweden, will be eligible for enrollment by a physician\u2010staffed emergency medical service unit. Forty patients will be randomized in a 3:1 ratio to receive a single intravenous bolus of either levosimendan 2.5\u2009mg (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200930) or placebo (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910), administered during cardiopulmonary resuscitation via prefilled, masked syringes. Both groups will receive routine advanced life support and postresuscitation care as applicable. Included patients eligible for hospital transfer will be admitted to Karolinska University Hospital in Solna, Stockholm, Sweden. The primary endpoint is 30\u2010day survival. Secondary endpoints include additional clinical outcome measures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The LeiCA pilot trial will investigate the effects of levosimendan as an adjunct to advanced life support for refractory OHCA. The results will inform the design of a definitive multicenter trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ISRCTN15862521; October 22, 2025<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.70159","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T07:00:21Z","timestamp":1764054021000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Levosimendan in Cardiac Arrest (\n                    <scp>LeiCA<\/scp>\n                    ): Protocol for a Randomized, Double\u2010Blind, Phase\n                    <scp>II<\/scp>\n                    Clinical Trial"],"prefix":"10.1111","volume":"70","author":[{"given":"Susanne","family":"Rysz","sequence":"first","affiliation":[{"name":"Perioperative Medicine and Intensive Care, Karolinska University Hospital  Stockholm Sweden"},{"name":"Section of Anesthesiology and Intensive Care Medicine, Department of Physiology and Pharmacology Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7826-1708","authenticated-orcid":false,"given":"Benjamin","family":"Flam","sequence":"additional","affiliation":[{"name":"Perioperative Medicine and Intensive Care, Karolinska University Hospital  Stockholm Sweden"},{"name":"Section of Anesthesiology and Intensive Care Medicine, Department of Physiology and Pharmacology Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magnus","family":"Hedberg","sequence":"additional","affiliation":[{"name":"Perioperative Medicine and Intensive Care, Karolinska University Hospital  Stockholm Sweden"},{"name":"Section of Anesthesiology and Intensive Care Medicine, Department of Physiology and Pharmacology Karolinska Institutet  Stockholm Sweden"},{"name":"Rapid Response Car, Ambulance Care in Greater Stockholm Ltd. 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