The need for inotropic drugs in anesthesiology and intensive care

The management of the failing heart represents an increasingly frequent challenge to both anesthesiologists and intensive care physicians, due to the increased prevalence of ventricular dysfunction in the population and to the ever-expanding indications for the surgical treatment of cardiac disease. Inotropic drugs are nowadays invaluable therapeutic tools in the treatment of perioperative heart failure and of the different forms of heart failure found in intensive care unit clinical practice. Postoperative myocardial dysfunction is a major concern in the setting of cardiac surgery since it is extremely frequent and is related to a greater morbidity and mortality. The different forms of heart failure, the rationale and the indications for the use of inotropic drugs in anesthesiology and intensive care are discussed in this review.