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Inotropic agents in critical illness 

Inotropic agents in critical illness
Chapter:
Inotropic agents in critical illness
Author(s):

Abdallah Fayssoil

and Djillali Annane

DOI:
10.1093/med/9780199600830.003.0036
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date: 30 November 2020

Inotropes are drugs commonly used in the intensive care unit. This class of agents includes a broad variety of molecules that improve cardiac index by increasing intracellular concentrations of cyclic AMP, or sensitivity to intracellular calcium, or by inhibiting the sodium/potassium pump. The main inotropic agents available are digoxin, catecholamines, and non-catecholergic drugs, e.g. phosphodiesterase inhibitors and levosimendan. In practice, dobutamine, a beta1 and beta2 agonist, is the inotrope of choice in patients with acute heart failure, or in patients with severe sepsis and evidence for left ventricle dysfunction. Levosimendan may be an alternative choice in patients with severe heart failure, particularly for those previously treated with beta-blockers. The main serious adverse events related to any inotrope are life-threatening arrhythmias.

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