Lozada Martinez ID, Bayona-Gamboa AJ, Meza-Fandiño DF, Paz-Echeverry OA, Ávila-Bonilla ÁM, Paz-Echeverry MJ, Pineda-Trujillo FJ, Rodríguez-García GP, Covaleda-Vargas JE, Narvaez-Rojas AR. Inotropic support in cardiogenic shock: who leads the battle, milrinone or dobutamine?
Ann Med Surg (Lond) 2022;
82:104763. [PMID:
36268289 PMCID:
PMC9577832 DOI:
10.1016/j.amsu.2022.104763]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
Cardiovascular diseases remain the leading cause of death globally, with acute myocardial infarction being one of the most frequent. One of the complications that can occur after a myocardial infarction is cardiogenic shock. At present, the evidence on the use of inotropic agents for the management of this complication is scarce, and only a few trials have evaluated the efficacy-adverse effects relationship of some agents. Milrinone and Dobutamine are some of the most frequently mentioned drugs that have been studied recently. However, there are still no data that affirm with certainty the supremacy of one over the other. The aim of this review is to synthesize evidence on basic and practical aspects of these agents, allowing us to conclude which might be more useful in current clinical practice, based on the emerging literature.
Studies suggest that Milrinone has a higher safety and efficacy profile over Dobutamine.
The evidence on the advantages of using Milrinone vs. Dobutamine is heterogeneous.
Additional factors need to be considered to reduce the risk of adverse events.
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