Current Paediatrics
Volume 13, Issue 1 , Pages 6-11, February 2003

Which inotrope?

  • Catherine R. Grebenik (Consultant Anaesthetist)

      Affiliations

    • Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, OX3 9DU, UK
  • ,
  • Michael E. Sinclair (Consultant Anaesthetist and Senior Clinical Lecturer)

      Affiliations

    • University of Oxford, Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, OX3 9DU, UK

Article Outline

Abstract 

A variety of inotropes are used to support the failing heart and improve arterial pressure. There is debate over the competing merits of the various agents available and a lack of good evidence on which to base clinical practice, particularly in paediatrics. Studies comparing the various agents have usually been performed on a small number of patients, and some have produced contradictory results. Recommendations are made based on the best evidence available and on the beliefs and personal experience of the authors.

Keywords: cardiac output low, paediatrics, adrenergic agonists, cardiotonic agents, phosphodiesterase inhibitors

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References 

    REFERENCES
  1. Juste RN, Moran L, Hooper J, Soni N. Dopamine clearance in critically ill patients. Intensive Care Med. 1998;24:1217–1220
  2. Burton CJ, Tomson CRV. Can the use of low dose dopamine for treatment of acute renal failure be justified?. Postgrad Med J. 1999;75:269–274
  3. Seri I. Cardiovascular, renal and endocrine actions of dopamine in neonates and children. J Pediatr. 1995;126:333–344
  4. Lancet. 2000;356:2139–2143
  5. Wenstone R, Campbell JM, Booker PD, McKay R. Renal function after cardiopulmonary bypass in children: comparison of dopamine with dobutamine. Br J Anaesth. 1991;67:591–594
  6. Prins I, Plotz FB, Uiterwaal CS, van-Vught HJ. Low dose dopamine in neonatal and paediatric intensive care: a systematic review. Intensive Care Med. 2001;27:206–210
  7. Seri I, Evans J. Controversies in the diagnosis and management of hypotension in the newborn infant. Curr Opin Pediatr. 2001;13:116–123
  8. Subhedar NV, Shaw NJ. Dopamine versus dobutamine for hypotensive preterm infants. Cochrane Database Syst Rev. 2000;2:
  9. Osborn D, Evans N, Kluckow M. Randomized trial of dobutamine versus dopamine in preterm infants with low systemic blood flow. J Pediatr. 2002;140:183–191
  10. Cheung PY, Barrington KJ, Bigam D. The hemodynamic effects of dobutamine infusion in the chronically instrumented newborn piglet. Crit Care Med. 1999;27:558–564
  11. Cheung PY, Barrington KJ. The effects of dopamine and epinephrine on hemodynamics and oxygen metabolism in hypoxic anesthetized piglets. Crit Care. 2001;5:158–166
  12. Butterworth JF IV, Prielipp RC, Royster RL. Dobutamine increases heart rate more than epinephrine in patients recovering from aortocoronary bypass surgery. J Cardiothor Vasc Anesth. 1992;6:535–541
  13. Voelkel NF, Hegstrand L, Reeves JT, McMurty IF, Molinoff PB. Effects of hypoxia on density of β-adrenergic receptors. J Appl Physiol. 1981;50:363
  14. Bernstein D, Voss E, Huang S. Differential regulation of right and left ventricular beta-adrenergic receptors in newborn lambs with experimental cyanotic congenital heart disease. J Clin Invest. 1990;85:68–74
  15. Gaissmaier RE, Pohlandt F. Single-dose dexamethasone treatment of hypotension in preterm infants. J Pediatr. 1999;134:701–705
  16. Royster RL, Butterworth JF IV, Prielipp RC. Combined inotropic effects of amrinone and epinephrine after cardiopulmonary bypass in humans. Anesthes Analg. 1993;77:662–672
  17. Bettendorf M, Schmidt KG, Grulich-Henn J, Ulmer HE, Heinrich UE. Tri-iodothyronine treatment in children after cardiac surgery: a double-blind, randomised, placebo-controlled study. Lancet. 2000;356:529–534
  • f1 Correspondence to CRG.: Tel.: 01865 221590; Fax.: 01865 221477; E-mail: kategreb@btinternet.com

PII: S0957-5839(03)90401-5

doi:10.1054/cupe.2003.0401

Current Paediatrics
Volume 13, Issue 1 , Pages 6-11, February 2003