Imperial College London
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Professor Anthony Gordon

Faculty of Medicine, Department of Surgery & Cancer

Chair in Anaesthesia and Critical Care
 
 
 
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Contact

 

anthony.gordon

 
 
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Location

 

ICUQueen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Scheeren:2021:10.1186/s13613-021-00806-8,
author = {Scheeren, TWL and Bakker, J and Kaufmann, T and Annane, D and Asfar, P and Boerma, EC and Cecconi, M and Chew, MS and Cholley, B and Cronhjort, M and De, Backer D and Dubin, A and Duenser, MW and Duranteau, J and Gordon, AC and Hajjar, LA and Hamzaoui, O and Hernandez, G and Kanoore, Edul V and Koster, G and Landoni, G and Leone, M and Levy, B and Martin, C and Mebazaa, A and Monnet, X and Morelli, A and Payen, D and Pearse, RM and Pinsky, MR and Radermacher, P and Reuter, DA and Sakr, Y and Sander, M and Saugel, B and Singer, M and Squara, P and Vieillard-Baron, A and Vignon, P and Vincent, J-L and van, der Horst ICC and Vistisen, ST and Teboul, J-L},
doi = {10.1186/s13613-021-00806-8},
journal = {Annals of Intensive Care},
title = {Current use of inotropes in circulatory shock},
url = {http://dx.doi.org/10.1186/s13613-021-00806-8},
volume = {11},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundTreatment 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.MethodsFrom 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.ResultsA 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).ConclusionInotrope use in critically ill patients is quite heterogeneous as self-reported by individual caregivers. Eleven strong recommendations on the indications, choice, triggers a
AU  - Scheeren,TWL
AU  - Bakker,J
AU  - Kaufmann,T
AU  - Annane,D
AU  - Asfar,P
AU  - Boerma,EC
AU  - Cecconi,M
AU  - Chew,MS
AU  - Cholley,B
AU  - Cronhjort,M
AU  - De,Backer D
AU  - Dubin,A
AU  - Duenser,MW
AU  - Duranteau,J
AU  - Gordon,AC
AU  - Hajjar,LA
AU  - Hamzaoui,O
AU  - Hernandez,G
AU  - Kanoore,Edul V
AU  - Koster,G
AU  - Landoni,G
AU  - Leone,M
AU  - Levy,B
AU  - Martin,C
AU  - Mebazaa,A
AU  - Monnet,X
AU  - Morelli,A
AU  - Payen,D
AU  - Pearse,RM
AU  - Pinsky,MR
AU  - Radermacher,P
AU  - Reuter,DA
AU  - Sakr,Y
AU  - Sander,M
AU  - Saugel,B
AU  - Singer,M
AU  - Squara,P
AU  - Vieillard-Baron,A
AU  - Vignon,P
AU  - Vincent,J-L
AU  - van,der Horst ICC
AU  - Vistisen,ST
AU  - Teboul,J-L
DO  - 10.1186/s13613-021-00806-8
PY  - 2021///
SN  - 2110-5820
TI  - Current use of inotropes in circulatory shock
T2  - Annals of Intensive Care
UR  - http://dx.doi.org/10.1186/s13613-021-00806-8
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000616392000002&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-021-00806-8
UR  - http://hdl.handle.net/10044/1/86593
VL  - 11
ER  -
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