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Table 4 Summary of literature search findings

From: Bench-to-bedside review: Inotropic drug therapy after adult cardiac surgery – a systematic literature review

Agent Total number of studies 'Level I' studies 'Level II' studies Significant findings
Epinephrine 15 0 10 Increases CI with biphasic effect on SVR index. Produces rise in serum lactate
Dopamine 22 0 14 Increased SVR index at doses above 5.0 μg/kg per min. Less clinical efficacy than dobutamine, dopexamine, amrinone, or enoximone. Increased incidence of adverse cardiac events than with dopexamine
Dobutamine 23 0 18 Better efficacy than dopamine and epinephrine. Decreases SVR index. Tachycardia and tachyarrythmia (especially AF) associated with use. More ischaemic complications than with amrinone
Dopexamine 20   12 Greater tachycardia than with dobutamine. More efficacious and fewer adverse events than with dopamine.
Amrinone 27 1 13 Improved weaning from CPB. Improves CI and decreases SVR index with minimal effects on HR. Fewer ischaemic complications than with dobutamine. Reports of thrombocytopenia associated with use
Enoximone 24 0 15 Significant increase in CI without tachycardia. Decreases SVR index. As effective as dobutamine
Milrinone 27 0 17 Significant increase in CI without tachycardia. Decreases SVR index. As effective as dobutamine but less AF. Luistropic. Improves IMA graft flow. As effective as 20 ppm NO in pulmonary hypertension
  1. AF, atrial fibrillation; CI, cardiac index; CPB, cardiopulmonary bypass; HR, heart rate; IMA, internal mammary artery; NO, nitric oxide; SVR, systemic vascular resistance.
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