Liberal Versus Restrictive Use of Dobutamine in Cardiac Surgery
Status:
Completed
Trial end date:
2018-06-01
Target enrollment:
Participant gender:
Summary
Inotropic agents are usually administered in the postoperative period after cardiac surgery.
In most cases, dobutamine is administered routinely, for the probable occurrence of
myocardial dysfunction after cardiopulmonary bypass or a low cardiac output with minimal
evidence of altered tissue perfusion.
Recent data show that inotropic agents are used in 35-52% of cardiac surgeries in the
perioperative period. However, the use of inotropic agents may be associated with adverse
events, including myocardial ischemia, by elevation in myocardial oxygen consumption and the
imbalance between supply and consumption, and tachyarrhythmias (atrial fibrillation, sinus
tachycardia, ventricular tachyarrhythmias), primarily due to the β1-adrenergic effect.
This study is a non-inferiority clinical randomized study aiming to compare the use of
dobutamine in a liberal strategy (in all patients at the time of withdrawal of CPB) with a
restrictive strategy (based on clinical and hemodynamic evidence of low cardiac output
syndrome associated with altered tissue perfusion). Our primary hypothesis is that the
restrictive use of dobutamine is as safe and effective as the liberal one.