The spectrum of cardiovascular effects of dobutamine - from healthy subjects to septic shock patients
Open accessAbstract
Dobutamine is the inotrope most commonly used in septic shock patients to increase cardiac output and correct hypoperfusion. Although some experimental and clinical studies have shown that dobutamine can improve systemic and regional hemodynamics, other research has found that its effects are heterogenous and unpredictable. In this review, we analyze the pharmacodynamic properties of dobutamine and its physiologic effects. Our goal is to show that the effects of dobutamine might differ between healthy subjects, in experimental and clinical cardiac failure, in animal models and in patients with septic shock. We discuss evidence supporting the claim that dobutamine, in septic shock, frequently behaves as a chronotropic and vasodilatory drug, without evidence of inotropic action. Since the side effects are very common, and the therapeutic benefits are unclear, we suggest that dobutamine should be used cautiously in septic shock. Before a definitive therapeutic decision, the efficacy and tolerance of dobutamine should be assessed during a brief time with close monitoring of its positive and negative side effects.
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There is considerable practice variation in duration of antimicrobial therapy for critically ill patients.
“Given the lack of definitive and generalizable data regarding the optimal duration of therapy for patients who are critically ill, it is not surprising that there is considerably practice variation (281,294).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [294]
The Introduction and 'Effects of Dobutamine in Septic Shock' sections discuss resuscitation and variable responses to dobutamine, not antimicrobial treatment. Searches for antimicrobial therapy duration, optimal antibiotic duration, and practice variation found no passage addressing the claim; the indexed passages provide no page numbers. (LLM, conf=0.75)
Experimental — accuracy not yet measuredIn sepsis, the inotropic response may be blunted with a preserved chronotropic effect causing tachycardia without increased stroke volume.
“In addition, the inotropic response may be blunted in sepsis with a preserved chronotropic effect causing tachycardia without an increase in stroke volume (SV) [370].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [370]
Dobutamine effects may not be predictable.
“However, these effects may not be predictable [370].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [370]
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Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021.
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Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021
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The initial resuscitation of septic shock
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- Authors
- Dubin, A., Lattanzio, B., & Gatti, L.
- Affiliations
- Universidad Nacional de La Plata (AR)
- Venue
- Revista Brasileira de Terapia Intensiva
- Published
- 2017
- Volume
- 29
- Issue
- 4
- Pages
- 490-498
- ISSN
- 0103-507X (ISSN-L)
- PMC
- PMC5764562
- OpenAlex
- W2782849077
- Cited by
- 56
- References
- 54
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 17 · 2023: 7 · 2022: 11 · 2021: 7 · 2020: 2 · 2019: 6
- FWCI
- 0.29
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc
- Locations
- Revista Brasileira de Terapia Intensiva (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc-sa)
- Americanae (AECID Library) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Keywords
- dobutamine, septic shock, inotropic agents, chronotropic effect, vasodilation, cardiac output, hemodynamics, heart failure, pharmacodynamics, adverse drug reactions, hypoperfusion
- MeSH terms
- Animals, Cardiac Output, Cardiotonic Agents, Dobutamine, Hemodynamics, Humans, Shock, Septic, Drug Monitoring
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