What Inotrope and Why?

Clin Perinatol. 2020 Sep;47(3):529-547. doi: 10.1016/j.clp.2020.05.010. Epub 2020 May 15.

Abstract

Primary function of cardiovascular system is to meet body's metabolic demands. The aim of inotrope therapy is to minimise adverse impact of cardiovascular compromise. Current use of inotropes is primarily guided by the pathophysiology of cardiovascular compromise and anticipated actions of inotropes. Lack of significant reduction in morbidity and mortality associated with cardiovascular compromise despite inotrope use, highlights major gaps in our understanding of circulatory targets, thresholds and choices of inotrope therapy. Thus far, prevention of cardiovascular compromise remains the most effective strategy to optimize outcomes. Studies of alternative design are needed for further advancement in cardiovascular therapy in neonates.

Keywords: Cardiovascular compromise; Hypotension; Inotrope; Newborn.

Publication types

  • Review

MeSH terms

  • Cardiac Output
  • Cardiotonic Agents / therapeutic use*
  • Dobutamine / therapeutic use
  • Dopamine / therapeutic use
  • Echocardiography
  • Epinephrine / therapeutic use
  • Heart / diagnostic imaging
  • Humans
  • Hypotension / diagnosis
  • Hypotension / drug therapy*
  • Hypotension / physiopathology
  • Infant, Newborn
  • Lactic Acid / blood
  • Milrinone / therapeutic use
  • Norepinephrine / therapeutic use
  • Perfusion Index
  • Skin / blood supply
  • Spectroscopy, Near-Infrared
  • Ultrasonography
  • Urination
  • Vasopressins / therapeutic use

Substances

  • Cardiotonic Agents
  • Vasopressins
  • Lactic Acid
  • Dobutamine
  • Milrinone
  • Dopamine
  • Norepinephrine
  • Epinephrine