CARDIOGENIC SHOCK: Edited by Alexandre Mebazaa

Inotropic agents in cardiogenic shock

Polyzogopoulou, Eftihiaa,∗; Arfaras-Melainis, Angelosb,d,∗; Bistola, Vasilikib; Parissis, Johnc

Author Information

aEmergency Medicine Department, Attikon University Hospital

bSecond Cardiology Department, Attikon Hospital, Medical School

cSecond Cardiology Department, Head of Emergency Medicine Department, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece

dDepartment of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA

Correspondence to John Parissis, Second Cardiology Department, Head of Emergency Medicine Department, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece. E-mail: [email protected]

Current Opinion in Critical Care 26(4):p 403-410, August 2020. | DOI: 10.1097/MCC.0000000000000744

Abstract

Purpose of review 

Cardiogenic shock is a multifactorial and diverse entity in which inotropes are the cornerstone therapy. Although published clinical trials have focused on pharmacologic treatment of cardiogenic shock, there is lack of an established and widely accepted decision-making algorithm on the use of inotropic agents in cardiogenic shock.

Recent findings 

The current review incorporates cardiogenic shock pathophysiology, inotropes and vasopressors pharmacodynamics. It emphasizes on each agent's indications, potential adverse effects, highlights special considerations and fsummarizes the recent guidelines.

Summary 

Finally, proposes an algorithm of inotropes and vasopressors use and their potential combinations based on the clinical stage of cardiogenic shock. This algorithm can be used as a guide during the initial management of cardiogenic shock while underlying cause investigation is underway.

Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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