A Study on the Pattern of Inotropes use in an Intensive Care Unit

Abstract

Inotropic stimulation of the heart is central to the regulation of cardiovascular function and has been used clinically for
decades. Unfortunately, inotropic agents have failed to show beneficial effects beyond short term hemodynamic
improvement. Clinical guidelines recommend targeted use of positive inotropic agents in highly selected patients, but data
are limited, and the recommendations are not specific. To review the pattern of inotropes, use in intensive care unit and to
verify the accuracy of prescribed doses, their effect on hemodynamic management and to investigate to what extent
specific factors influence the ICU length of stay and mortality. It is a prospective, observational research work conducted
at Apollo hospitals, Jubilee Hills, Hyderabad, a tertiary care center. A structured proforma was designed to collect the
information from patients of all age groups with a varied diagnosis, who are on inotropes. Collected data was analyzed for
the pattern of inotropes used, their doses and the factors influencing the ICU length of stay and mortality. A total of 200
cases were collected and analyzed. Noradrenaline was the most commonly used inotrope (27.5%) and was also associated
with a greater length of stay. Renal failure, hepatic failure, respiratory failure, hemodynamic parameters, and GCS
prolonged ICU length of stay. The mortality rate was seen to be 20 % among ICU patients. This research work reviewed
currently available inotropes and their specific uses in critical care. Hospital pattern of use of inotropes showed
predominant use of noradrenaline, followed by dobut amine, and their combinations. Inotropes prescribed were according
to the standard guidelines. Association of inotropes uses with mortality was analyzed in ICU patients.