Dr Kenneth Tan. MBBS MMed(Anaes) MRCP(UK) EDIC FCCP Anesthesia and Intensive Care Services Mount Elizabeth Hospital
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1 Dr Kenneth Tan MBBS MMed(Anaes) MRCP(UK) EDIC FCCP Anesthesia and Intensive Care Services Mount Elizabeth Hospital
2 Adrenergic receptor agnoists Adrenaline Noradernaline Dobutamine Dopamine Phosphodiesterase Inhibitor Milrinone Amrinone Calcium sensitiser Levosimendan Vasopressin?
3 Circulation. 2008;118:
4 Circulation. 2008;118:
5 Dopamine Alpha Beta Beta 2 ++ Dopaminergic Dobutamine Alpha + Beta Beta Adrenaline Alpha Beta Beta Noradrenaline Alpha Beta Beta 2 ++ Table. Inotropicand Vasopressor Drug Names, C
6 PDI e.g. Milrinone Increases intracellular camp Increases inotropy, lusitropy and vasodilatation Circulation. 2008;118:
7 Calcium Sensitisers e.g. Levosimendan Sensitises binding of calcium to troponin C Opens ATP dependent potassium channels Leads to increases in inotropy without increasing intracellular calcium and impairment of diastolic relaxation. Vascular vasodilation
8 Vasopressin Not strictly an inotrope V1a receptors causing vasoconstriction V2 receptors causing water reabsorption Increases vasoconstriction of noradrenaline Inhibits ATP activated potassium channels Reverses adrenergic downregulation Inhibits NO production
9 PubMed Search terms: Cardiogenic shock and Dopamine Cardiogenic shock and Dobutamine Cardiogenic shock and Adrenaline Cardiogenic shock and Noradrenaline Cardiogenic shock and levosimendan Cardiogenic shock and Milrinone
10 270 Articles 1: Levy B, Perez P, Perny J, Thivilier C, Gerard A. Comparison of norepinephrine-dobutamine to epinephrine for hemodynamics, lactate metabolism, and organ function variables in cardiogenic shock. A prospective, randomized pilot study. Crit Care Med Oct 28. [Epub ahead of print] PubMed PMID: : De Backer D, Biston P, Devriendt J, Madl C, Chochrad D, Aldecoa C, Brasseur A, Defrance P, Gottignies P, Vincent JL; SOAP II Investigators. Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med Mar 4;362(9): PubMed PMID: : Obaid L, Johnson ST, Emara M, Bigam DL, Cheung PY. Epinephrine versus dopamine to treat shock in hypoxic newborn pigs resuscitated with 100% oxygen. Shock Feb;29(2): PubMed PMID:
![2010 Oct 28. [Epub ahead of print] PubMed PMID:21037469. 2: De Backer D, Biston P, Devriendt J, Madl C, Chochrad D, Aldecoa C, Brasseur A, Defrance P, Gottignies P, Vincent JL; SOAP II Investigators.](/docs-images/43/11861886/images/page_10.jpg "Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med. 2010 Mar 4;362(9):779-89. PubMed PMID: 20200382. 3: Obaid L, Johnson ST, Emara M, Bigam DL, Cheung PY.")
11 232 Articles 1: Levy B, Perez P, Perny J, Thivilier C, Gerard A. Comparison of norepinephrine-dobutamine to epinephrine for hemodynamics, lactate metabolism,and organ function variables in cardiogenic shock. A prospective, randomizedpilot study. Crit Care Med Oct 28. [Epub ahead of print] PubMed PMID: : De Backer D, Biston P, Devriendt J, Madl C, Chochrad D, Aldecoa C, Brasseur A,Defrance P, Gottignies P, Vincent JL; SOAP II Investigators. Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med Mar 4;362(9): PubMed PMID:
![A prospective, randomizedpilot study. Crit Care Med. 2010 Oct 28. [Epub ahead of print] PubMed PMID: 21037469.](/docs-images/43/11861886/images/page_11.jpg "2: De Backer D, Biston P, Devriendt J, Madl C, Chochrad D, Aldecoa C, Brasseur A,Defrance P, Gottignies P, Vincent JL; SOAP II Investigators.")
12 263 articles 1: Obaid L, Johnson ST, Emara M, Bigam DL, Cheung PY. Epinephrine versus dopamine to treat shock in hypoxic newborn pigs resuscitated with 100% oxygen. Shock Feb;29(2): PubMed PMID: : De Backer D, Biston P, Devriendt J, Madl C, Chochrad D, Aldecoa C, Brasseur A, Defrance P, Gottignies P, Vincent JL; SOAP II Investigators. Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med Mar 4;362(9): PubMed PMID: : Levy B, Perez P, Perny J, Thivilier C, Gerard A. Comparison of norepinephrine-dobutamine to epinephrine for hemodynamics, lactate metabolism, and organ function variables in cardiogenic shock. A prospective, randomized pilot study. Crit Care Med Oct 28. [Epub ahead of print] PubMed PMID: : Bagwell EE, Daniell HB. Comparative effects of dopamine and norepinephrine on myocardial function and metabolism during experimental cardiogenic shock. J Pharmacol Exp Ther Jun;173(2): PubMed PMID:
13 147 Articles 1: Levy B, Perez P, Perny J, Thivilier C, Gerard A. Comparison of norepinephrine-dobutamine to epinephrine for hemodynamics, lactate metabolism, and organ function variables in cardiogenic shock. A prospective, randomized pilot study. Crit Care Med Oct 28. [Epub ahead of print] PubMed PMID: : Samimi-Fard S, García-González MJ, Domínguez-Rodríguez A, Abreu-González P. Effects of levosimendan versus dobutamine on long-term survival of patients with cardiogenic shock after primary coronary angioplasty. Int J Cardiol Jul 4;127(2): Epub 2007 Jul 23. PubMed PMID:
![A prospective, randomized pilot study. Crit Care Med. 2010 Oct 28. [Epub ahead of print] PubMed PMID: 21037469.](/docs-images/43/11861886/images/page_13.jpg "2: Samimi-Fard S, García-González MJ, Domínguez-Rodríguez A, Abreu-González P.")
14 63 articles 1: Samimi-Fard S, García-González MJ, Domínguez-Rodríguez A, Abreu-González P. Effects of levosimendan versus dobutamine on long-term survival of patients with cardiogenic shock after primary coronary angioplasty. Int J Cardiol Jul 4;127(2): Epub 2007 Jul 23. PubMed PMID: : De Luca L, Colucci WS, Nieminen MS, Massie BM, Gheorghiade M. Evidence-based use of levosimendan in different clinical settings. Eur Heart J Aug;27(16): Epub 2006 Apr 27. Review. PubMed PMID:
15 24 Articles 1: Beute J. Levosimendan is superior to enoximone in refractory cardiogenic shock complicating acute myocardial infarction. Crit Care Med Aug(36): : Samimi-Fard S, García-González MJ, Domínguez-Rodríguez A, Abreu-González P. Effects of levosimendan versus dobutamine on long-term survival of patients with cardiogenic shock after primary coronary angioplasty. Int J Cardiol Jul 4;127(2): Epub 2007 Jul 23. PubMed PMID:
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