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Current use of inotropes in circulatory shock
Thomas W L Scheeren1, Jan Bakker2,3,4,5, Thomas Kaufmann6
1Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O.Box 30.001, 9700 RB, Groningen, The Netherlands. t.w.l.scheeren@umcg.nl.
Annals of Intensive Care
|January 29, 2021
Summary
Inotrope therapy for circulatory shock shows varied practices among physicians. International experts propose 11 strong recommendations for inotrope use in critically ill patients to improve consistency.
Area of Science:
- Critical Care Medicine
- Cardiology
- Pharmacology
Background:
- Treatment decisions for critically ill patients with circulatory shock lack consensus.
- International survey to evaluate inotrope therapy indications, practice, and goals.
Purpose of the Study:
- To assess current practices and expert recommendations for inotrope use in circulatory shock.
- To identify areas of consensus and heterogeneity in inotrope therapy.
Main Methods:
- Anonymous web-based survey of 839 physicians from 82 countries.
- 11-question survey for 42 international experts to formulate recommendations.
Main Results:
- Dobutamine is the preferred first-line inotrope (84%).
- Inotropes used for persistent hypoperfusion/hyperlactatemia (66%) or low ejection fraction.
- Experts agreed on 11 strong recommendations for indications, drug choice, triggers, and targets.
Conclusions:
- Inotrope use in critically ill patients is heterogeneous.
- 11 expert recommendations provide guidance on inotrope indications, choice, triggers, and targets.
- Future research should focus on consistent indications and individualized targets for inotrope use in circulatory shock.
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