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心源性休克中的正性肌力支持:谁能主导战局,米力农还是多巴酚丁胺?

Inotropic support in cardiogenic shock: who leads the battle, milrinone or dobutamine?

作者信息

Lozada Martinez Ivan David, Bayona-Gamboa Andrea Juliana, Meza-Fandiño Duvier Fabián, Paz-Echeverry Omar Andrés, Ávila-Bonilla Ángela María, Paz-Echeverry Mario Javier, Pineda-Trujillo Frank Jaider, Rodríguez-García Gina Paola, Covaleda-Vargas Jaime Enrique, Narvaez-Rojas Alexis Rafael

机构信息

Medical and Surgical Research Center, Future Surgeons Chapter, Colombian Surgery Association, Bogotá, Colombia.

Grupo Prometheus y Biomedicina Aplicada a las Ciencias Clínicas, School of Medicine, Universidad de Cartagena, Cartagena, Colombia.

出版信息

Ann Med Surg (Lond). 2022 Sep 22;82:104763. doi: 10.1016/j.amsu.2022.104763. eCollection 2022 Oct.

Abstract

Cardiovascular diseases remain the leading cause of death globally, with acute myocardial infarction being one of the most frequent. One of the complications that can occur after a myocardial infarction is cardiogenic shock. At present, the evidence on the use of inotropic agents for the management of this complication is scarce, and only a few trials have evaluated the efficacy-adverse effects relationship of some agents. Milrinone and Dobutamine are some of the most frequently mentioned drugs that have been studied recently. However, there are still no data that affirm with certainty the supremacy of one over the other. The aim of this review is to synthesize evidence on basic and practical aspects of these agents, allowing us to conclude which might be more useful in current clinical practice, based on the emerging literature.

摘要

心血管疾病仍然是全球主要的死亡原因,急性心肌梗死是最常见的原因之一。心肌梗死后可能出现的并发症之一是心源性休克。目前,关于使用正性肌力药物治疗这种并发症的证据很少,只有少数试验评估了某些药物的疗效-不良反应关系。米力农和多巴酚丁胺是最近研究中最常被提及的一些药物。然而,仍然没有数据能够确定地证实其中一种药物优于另一种。本综述的目的是综合这些药物在基础和实际方面的证据,使我们能够根据新出现的文献得出哪种药物在当前临床实践中可能更有用的结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0018/9577832/cd81ccf1bef2/gr1.jpg

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