3.15 Inotropes

In this episode, we review the use of inotropes in acute decompensated heart failure and cardiogenic shock? What are the effects of activating alpha-1 receptors, beta-1 receptors, and beta-2 receptors? What are the effects of inhibiting phosphodiesterase-5? What is the vasoconstriction-vs-inotropy-plot and where does each inotrope and vasopressor sit on the plot with respect to the intropy=0 vertical line or the vasoconstriction=0 horizontal line? In a patient with pulmonary hypertension with >3 Woods units of pulmonary vascular resistance, is dobutamine or milrinone a more appropriate choice? In a patient with acute kidney injury, is dobutamine or milrinone a more appropriate choice? What are the main contraindications for each inotrope? Tune in for answers to these questions.

Difficulty Level: Intermediate

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