Optimal Inotropic Support Strategy in Low Cardiac Output Syndrome

Low cardiac output syndrome (LCOS), a form of cardiogenic shock that occurs after cardiac surgery, is associated with an elevated risk of morbidity and mortality. Generally, LCOS is managed medically with inotropes and vasopressors to optimize hemodynamics. However, randomized data comparing the efficacy of individual inotropes in treating LCOS are limited. Consequently, there is little consensus regarding the optimal inotrope strategy, and practice patterns vary widely. This review synthesizes current evidence on pharmacologic, non-mechanical circulatory support strategies for managing LCOS, advocating for a personalized approach tailored to the individual patient's hemodynamic profile and inotropic requirements. Currently available vasoactive agents are discussed, and guidance is provided on their use across specific clinical contexts to support individualized treatment.