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Thursday, September 30, 2021

Milrinone vs Dobutamine

of Cardiogenic Shock
REBEL EM - September 30, 2021 - By Mark Ramzy
Paper: Mathew R, et al. Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock. N Engl J Med. 2021 Aug 5. PMID: 34347952
Clinical Question: What is the efficacy and safety of Milrinone compared to Dobutamine in patients with cardiogenic shock?
Clinical Bottom Line:
There was no significant difference in the primary composite outcome between milrinone and dobutamine in patients with classic or deteriorating cardiogenic shock in this single-center trial with a small sample size. The lack of difference found in this trial could simply be because initiation of therapy may have been too late in the clinical course of illness as is seen by the high mortality rates in this population across both groups. The decision on which drug to use should be tailored to institutional availability, cost, nursing familiarity, the individual patient and their clinical condition.