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Digoxin in the critically ill patient.

L I Worthley1, A W Holt

  • 1Department of Critical Care Medicine, Flinders Medical Centre, Adelaide, SA 5042, Australia lindsay.Worthley@flinders.edu.au.

Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine
|April 11, 2006
PubMed
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Digoxin is a heart medication used for systolic heart failure and supraventricular tachycardia. While less common in critical care, it may benefit septic shock patients, but more research is needed.

Area of Science:

  • Pharmacology and Toxicology
  • Cardiology
  • Critical Care Medicine

Background:

  • Digoxin is a cardiac glycoside that inhibits NaK-ATPase, impacting myocardial contractility, neural tissue, and smooth muscle.
  • Its established uses include systolic heart failure and supraventricular tachycardia management.

Purpose of the Study:

  • To review the pharmacodynamic and pharmacokinetic properties of digoxin.
  • To evaluate the potential use and toxic effects of digoxin in critically ill patients.

Main Methods:

  • Literature review of studies from 1966 to 1998.
  • MEDLINE search for digoxin and critical illness.

Main Results:

  • Digoxin is less frequently used in critical care due to agents with superior inotropic effects and better arrhythmia control.

Related Experiment Videos

  • Potential benefit in septic shock is suggested by early studies showing improved myocardial dysfunction with intravenous digoxin, but large trials are lacking.
  • Contraindicated in critical coronary artery disease and ischemic or hypertrophic diastolic failure.

    • Conclusions:

    • Digoxin is a unique therapeutic agent for systolic heart failure and supraventricular tachycardia.
    • Consider a single dose in septic shock patients not previously on digoxin, alongside other treatments.
    • Avoid in critical coronary artery disease and specific types of diastolic heart failure.