Numerous studies have questioned the practice of using dobutamine in cardiac failure. Despite that, most guidelines for supportive treatment of decompensated cardiac failure still include dobutamine. A recently published meta-analysis has another go at it.
In the study, from Intensive Care Medicine, the researchers identified RCTs that compared dobutamine with placebo or no treatment of severe heart failure as defined by NYHA classes III or IV. They found 14 usable studies including a total of 673 patients.
The results are depressing but not surprising.
There was no association between dobutamine and improved survival. There might rather be a trend suggesting increased mortality in patients being treated with dobutamin
The identified studies and their outcomes are summarised in the table below. (Click image to open enlarged version in a separate window.)
So chances are dobutamine against proper cardiac failure is another case of polishing the numbers while disregarding the basic patophysiology of the disease we are trying to treat. With dobutamine we improve the numbers on the monitor but at the same time fry the poor oxygen-deprived myocytes.
The study is here.