7
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Current use of inotropes in circulatory shock

      research-article
      1 , , 2 , 3 , 4 , 5 , 1 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 26 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 29 , 30
      Annals of Intensive Care
      Springer International Publishing
      Acute circulatory failure, Sepsis, Septic shock, Cardiogenic shock, Resuscitation, Inotropes, Vasoactive agents, Catecholamines, Levosimendan, PDE-inhibitors, Cardiac output

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Treatment decisions on critically ill patients with circulatory shock lack consensus. In an international survey, we aimed to evaluate the indications, current practice, and therapeutic goals of inotrope therapy in the treatment of patients with circulatory shock.

          Methods

          From November 2016 to April 2017, an anonymous web-based survey on the use of cardiovascular drugs was accessible to members of the European Society of Intensive Care Medicine (ESICM). A total of 14 questions focused on the profile of respondents, the triggering factors, first-line choice, dosing, timing, targets, additional treatment strategy, and suggested effect of inotropes. In addition, a group of 42 international ESICM experts was asked to formulate recommendations for the use of inotropes based on 11 questions.

          Results

          A total of 839 physicians from 82 countries responded. Dobutamine was the first-line inotrope in critically ill patients with acute heart failure for 84% of respondents. Two-thirds of respondents (66%) stated to use inotropes when there were persistent clinical signs of hypoperfusion or persistent hyperlactatemia despite a supposed adequate use of fluids and vasopressors, with (44%) or without (22%) the context of low left ventricular ejection fraction. Nearly half (44%) of respondents stated an adequate cardiac output as target for inotropic treatment. The experts agreed on 11 strong recommendations, all of which were based on excellent (> 90%) or good (81–90%) agreement. Recommendations include the indications for inotropes (septic and cardiogenic shock), the choice of drugs (dobutamine, not dopamine), the triggers (low cardiac output and clinical signs of hypoperfusion) and targets (adequate cardiac output) and stopping criteria (adverse effects and clinical improvement).

          Conclusion

          Inotrope use in critically ill patients is quite heterogeneous as self-reported by individual caregivers. Eleven strong recommendations on the indications, choice, triggers and targets for the use of inotropes are given by international experts. Future studies should focus on consistent indications for inotrope use and implementation into a guideline for circulatory shock that encompasses individualized targets and outcomes.

          Related collections

          Most cited references44

          • Record: found
          • Abstract: not found
          • Article: not found

          2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016.

            To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012".
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Improving the Quality of Web Surveys: The Checklist for Reporting Results of Internet E-Surveys (CHERRIES)

              Analogous to checklists of recommendations such as the CONSORT statement (for randomized trials), or the QUORUM statement (for systematic reviews), which are designed to ensure the quality of reports in the medical literature, a checklist of recommendations for authors is being presented by the Journal of Medical Internet Research (JMIR) in an effort to ensure complete descriptions of Web-based surveys. Papers on Web-based surveys reported according to the CHERRIES statement will give readers a better understanding of the sample (self-)selection and its possible differences from a “representative” sample. It is hoped that author adherence to the checklist will increase the usefulness of such reports.
                Bookmark

                Author and article information

                Contributors
                t.w.l.scheeren@umcg.nl
                j.bakker@erasmusmc.nl
                t.kaufmann@umcg.nl
                djillali.annane@aphp.fr
                piasfar@chu-angers.fr
                christiaan.boerma@mcl.nl
                maurizio.cecconi@hunimed.eu
                michelle.chew@liu.se
                bernard.cholley@aphp.fr
                maria.cronhjort@sll.se
                ddebacke@ulb.ac.be
                arnaldodubin@gmail.com
                Martin.Duenser@i-med.ac.at
                jacques.duranteau@aphp.fr
                anthony.gordon@imperial.ac.uk
                ludhmila@usp.br
                olfa.hamzaoui@aphp.fr
                glennguru@gmail.com
                vaninaedul@gmail.com
                g.koster@umcg.nl
                landoni.giovanni@hsr.it
                marc.leone@ap-hm.fr
                blevy5463@gmail.com
                ClaudeDenis.MARTIN@ap-hm.fr
                alexandre.mebazaa@aphp.fr
                xavier.monnet@aphp.fr
                andrea.morelli@uniroma1.it
                dpayen1234@orange.fr
                r.pearse@qmul.ac.uk
                pinsky@pitt.edu
                peter.radermacher@uni-ulm.de
                Daniel.Reuter@med.uni-rostock.de
                yasser.sakr@med.uni-jena.de
                Michael.Sander@chiru.med.uni-giessen.de
                bernd.saugel@gmx.de
                m.singer@ucl.ac.uk
                pierre.squara@orange.fr
                antoine.vieillard-baron@aphp.fr
                philippe.vignon@unilim.fr
                jlvincent@intensive.org
                iwan.vander.horst@mumc.nl
                vistisen@clin.au.dk
                jean-louis.teboul@aphp.fr
                Journal
                Ann Intensive Care
                Ann Intensive Care
                Annals of Intensive Care
                Springer International Publishing (Cham )
                2110-5820
                29 January 2021
                29 January 2021
                2021
                : 11
                : 21
                Affiliations
                [1 ]GRID grid.4494.d, ISNI 0000 0000 9558 4598, Department of Anesthesiology, , University of Groningen, University Medical Center Groningen, ; Hanzeplein 1, P.O.Box 30.001, 9700 RB Groningen, The Netherlands
                [2 ]GRID grid.240324.3, ISNI 0000 0001 2109 4251, New York University Medical Center, ; New York, USA
                [3 ]GRID grid.239585.0, ISNI 0000 0001 2285 2675, Columbia University Medical Center, ; New York, USA
                [4 ]GRID grid.5645.2, ISNI 000000040459992X, Erasmus MC University Medical Center Rotterdam, ; Rotterdam, The Netherlands
                [5 ]GRID grid.7870.8, ISNI 0000 0001 2157 0406, Pontificia Universidad Católica de Chile, ; Santiago, Chile
                [6 ]GRID grid.12832.3a, ISNI 0000 0001 2323 0229, School of Medicine Simone Veil, Raymond Poincaré Hospital (APHP), Department of Intensive Care Medicine, , University of Versailles- University Paris Saclay, ; Garches, France
                [7 ]GRID grid.7252.2, ISNI 0000 0001 2248 3363, Département de Médecine Intensive-Réanimation Et de Médecine Hyperbare, Centre Hospitalier Universitaire Angers; and Institut MITOVASC, , CNRS UMR 6215, INSERM U1083, Angers University, ; Angers, France
                [8 ]GRID grid.414846.b, ISNI 0000 0004 0419 3743, Medical Centre Leeuwarden, Department of Intensive Care, ; Leeuwarden, the Netherlands
                [9 ]GRID grid.417728.f, ISNI 0000 0004 1756 8807, Department of Anesthesia and Intensive Care, , IRCCS Humanitas Research Hospital, ; Via Manzoni 56, Milan, Italy
                [10 ]GRID grid.452490.e, Department of Biomedical Sciences, , Humanitas University, ; Via Rita Levi Montalcini, Milan, Italy
                [11 ]GRID grid.5640.7, ISNI 0000 0001 2162 9922, Department of Anaesthesiology and Intensive Care, Biomedical and Clinical Sciences, , Linköping University, ; Linköping, Sweden
                [12 ]GRID grid.414093.b, Department of Anaesthesiology & Intensive Care Medicine, , AP-HP, Hôpital Européen Georges Pompidou, ; Paris, France
                [13 ]GRID grid.508487.6, ISNI 0000 0004 7885 7602, Université de Paris, ; Paris, France
                [14 ]Section of Anaesthesiology and Intensive Care, Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
                [15 ]GRID grid.4989.c, ISNI 0000 0001 2348 0746, Department of Intensive Care, , CHIREC Hospitals, Université Libre de Bruxelles, ; Brussels, Belgium
                [16 ]GRID grid.9499.d, ISNI 0000 0001 2097 3940, Cátedra de Farmacología Aplicada, Facultad de Ciencias Médicas, , Universidad Nacional de La Plata Y Servicio de Terapia Intensiva, ; Sanatorio Otamendi, Buenos Aires, Argentina
                [17 ]GRID grid.9970.7, ISNI 0000 0001 1941 5140, Department of Anesthesiology and Intensive Care Medicine, , Kepler University Hospital and Johannes Kepler University Linz, ; Linz, Austria
                [18 ]GRID grid.413784.d, ISNI 0000 0001 2181 7253, Department of Anaesthesia and Intensive Care, , Assistance Publique Des Hopitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Université Paris-Saclay, Hôpital de Bicêtre, ; Le Kremlin-Bicêtre, France
                [19 ]GRID grid.7445.2, ISNI 0000 0001 2113 8111, Division of Anaesthetics, Pain Medicine and Intensive Care, , Imperial College London, ; London, UK
                [20 ]GRID grid.11899.38, ISNI 0000 0004 1937 0722, Department of Cardiopneumology, , Instituto Do Coracao, Universidade de São Paulo, Hospital SirioLibanes, ; São Paulo, Brazil
                [21 ]GRID grid.50550.35, ISNI 0000 0001 2175 4109, Assistance Publique-Hôpitaux de Paris, Paris Saclay University Hospitals, Antoine Béclère Hospital, ; Paris, France
                [22 ]GRID grid.7870.8, ISNI 0000 0001 2157 0406, Departamento de Medicina Intensiva, Facultad de Medicina, , Pontificia Universidad Católica de Chile, ; Santiago, Chile
                [23 ]GRID grid.414691.f, ISNI 0000 0004 0637 7108, Servicio de Terapia Intensiva, Hospital Fernández, ; Buenos Aires, Argentina
                [24 ]GRID grid.4494.d, ISNI 0000 0000 9558 4598, Department of Critical Care, , University of Groningen, University Medical Center Groningen, ; Groningen, the Netherlands
                [25 ]Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
                [26 ]GRID grid.5399.6, ISNI 0000 0001 2176 4817, Aix Marseille Université, Assistance Publique Hôpitaux de Marseille, Service D’Anesthésie Et de Réanimation CHU Nord, ; Marseille, France
                [27 ]GRID grid.29172.3f, ISNI 0000 0001 2194 6418, Service de Réanimation Médicale Brabois Et Pôle Cardio-Médico-Chirurgical. CHRU Brabois, , INSERM U1116, Université de Lorraine, ; Vandoeuvre les NancyNancy, 54500 France
                [28 ]Department of Anesthesia, Burn and Critical Care, APHP Hôpitaux Universitaires Saint Louis LariboisièreUniversité Paris DiderotU942 Inserm, Paris, France
                [29 ]GRID grid.50550.35, ISNI 0000 0001 2175 4109, Medical Intensive Care Unit, , Assistance Publique-Hôpitaux de Paris, Paris-Saclay University Hospitals, ; Bicêtre hospital, Le Kremlin-Bicêtre, France
                [30 ]GRID grid.462435.2, INSERM UMR_S 999, FHU SEPSIS, ; Le Kremlin-Bicêtre, France
                [31 ]GRID grid.7841.a, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, , Sapienza University of Rome, ; Rome, Italy
                [32 ]University Paris 7 Denis Diderot; INSERM 1160 and Hôpital Lariboisière, APHP, Paris, France
                [33 ]GRID grid.4868.2, ISNI 0000 0001 2171 1133, William Harvey Research Institute, Queen Mary University of London, ; London, EC1M 6BQ UK
                [34 ]GRID grid.21925.3d, ISNI 0000 0004 1936 9000, Department of Critical Care Medicine, , University of Pittsburgh, ; Pittsburgh, USA
                [35 ]GRID grid.410712.1, Institut Für Anästhesiologische Pathophysiologie Und Verfahrensentwicklung, , Universitätsklinikum Ulm, ; Ulm, Germany
                [36 ]GRID grid.10493.3f, ISNI 0000000121858338, Department of Anesthesiology and Intensive Care Medicine, , Rostock University Medical Centre, ; Rostock, Germany
                [37 ]GRID grid.275559.9, ISNI 0000 0000 8517 6224, Department of Anesthesiology and Intensive Care, , Uniklinikum Jena, ; Jena, Germany
                [38 ]Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Giessen, UKGM, Justus-Liebig University Giessen, Giessen, Germany
                [39 ]GRID grid.13648.38, ISNI 0000 0001 2180 3484, Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, , University Medical Center Hamburg-Eppendorf, ; Hamburg, Germany
                [40 ]GRID grid.83440.3b, ISNI 0000000121901201, Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, , University College London, ; London, UK
                [41 ]GRID grid.477172.0, ICU Department, , Réanimation CERIC, Clinique Ambroise Paré, ; Neuilly, France
                [42 ]GRID grid.50550.35, ISNI 0000 0001 2175 4109, Assistance Publique-Hôpitaux de Paris, University Hospital Ambroise Paré, ; intensive care unit, Boulogne-Billancourt, France
                [43 ]GRID grid.463845.8, ISNI 0000 0004 0638 6872, INSERM U-1018, CESP, Team 5, University of Versailles Saint-Quentin en Yvelines, ; Villejuif, France
                [44 ]Medical-Surgical Intensive Care Unit, INSERM CIC-1435, Teaching Hospital of Limoges, Limoges, France
                [45 ]GRID grid.9966.0, ISNI 0000 0001 2165 4861, University of Limoges, ; Limoges, France
                [46 ]GRID grid.412157.4, ISNI 0000 0000 8571 829X, Université Libre de Bruxelles - Dept of Intensive Care, , Erasme Univ Hospital, ; Brussels, Belgium
                [47 ]GRID grid.412966.e, ISNI 0000 0004 0480 1382, Department of Intensive Care Medicine, , Maastricht University Medical Center, ; Maastricht, The Netherlands
                [48 ]GRID grid.7048.b, ISNI 0000 0001 1956 2722, Institute of Clinical Medicine, , Aarhus University, ; Aarhus, Denmark
                [49 ]GRID grid.154185.c, ISNI 0000 0004 0512 597X, Department of Anesthesia and Intensive Care, , Aarhus University Hospital, ; Aarhus, Denmark
                Author information
                https://orcid.org/0000-0002-9184-4190
                https://orcid.org/0000-0003-3891-8522
                Article
                806
                10.1186/s13613-021-00806-8
                7846624
                33512597
                08315eb9-de4f-4bdc-bce8-73d2b375887f
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 30 October 2020
                : 9 January 2021
                Categories
                Research
                Custom metadata
                © The Author(s) 2021

                Emergency medicine & Trauma
                acute circulatory failure,sepsis,septic shock,cardiogenic shock,resuscitation,inotropes,vasoactive agents,catecholamines,levosimendan,pde-inhibitors,cardiac output

                Comments

                Comment on this article