Scandinavian SSAI clinical practice guideline on choice of inotropic agent for patients with acute circulatory failure

Acta Anaesthesiologica Scandinavica
M H MøllerA Perner

Abstract

Adult critically ill patients often suffer from acute circulatory failure and those with low cardiac output may be treated with inotropic agents. The aim of this Scandinavian Society of Anaesthesiology and Intensive Care Medicine guideline was to present patient-important treatment recommendations on this topic. This guideline was developed according to GRADE. We assessed the following subpopulations of patients with shock: (1) shock in general, (2) septic shock, (3) cardiogenic shock, (4) hypovolemic shock, (5) shock after cardiac surgery, and (6) other types of shock, including vasodilatory shock. We assessed patient-important outcome measures, including mortality and serious adverse reactions. For all patients, we suggest against the routine use of any inotropic agent, including dobutamine, as compared to placebo/no treatment (very low quality of evidence). For patients with shock in general, and in those with septic and other types of shock, we suggest using dobutamine rather than levosimendan or epinephrine (very low quality of evidence). For patients with cardiogenic shock and in those with shock after cardiac surgery, we suggest using dobutamine rather than milrinone (very low quality of evidence). For the other clinical...Continue Reading

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Citations

Dec 5, 2018·Acta Anaesthesiologica Scandinavica·Marius RehnMorten Hylander Møller
Oct 28, 2019·Intensive Care Medicine·James A Russell
Oct 2, 2020·Der Anaesthesist·T WoehrleE Kilger
Dec 17, 2019·Journal of Cardiothoracic and Vascular Anesthesia·Alessandro BellettiSilvia Ajello
Jan 27, 2021·Annals of Intensive Care·Rafael Alves FrancoLudhmila Abrahão Hajjar
Jul 6, 2021·European Heart Journal. Acute Cardiovascular Care·Jacqueline T DesJardin, John R Teerlink
Aug 3, 2021·Medizinische Klinik, Intensivmedizin und Notfallmedizin·Reimer Riessen, Rubi Stephani Hellwege
Oct 19, 2020·Journal of Cardiothoracic and Vascular Anesthesia·Alessandro BellettiGiovanni Landoni

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