Dobutamine: a hemodynamic evaluation in pulmonary embolism shock

Intravenous dobutamine was used in ten patients requiring aggressive therapy for massive pulmonary embolism with circulatory failure. Except in one patient who rapidly died, a 30-min dobutamine infusion (8.3 +/- 2.7 micrograms/kg . min) increased both cardiac index (from 1.7 +/- 0.4 to 2.3 +/- 0.6 L/min . m2, p less than .001) and stroke index (from 16.6 +/- 6.7 to 21 +/- 5 ml/m2, p less than .01), and also reduced pulmonary vascular resistance. Additional hemodynamic improvement was observed until weaning from dobutamine, which was successfully completed 3.3 +/- 0.9 days after the start of infusion.