Comparison of Outcomes Between Milrinone and Dobutamine in Patients With Cardiogenic Shock: A Meta-Analysis of Randomized Control Trials and Observational Studies.

The aim of this systematic review and meta-analysis was to compare the outcomes between milrinone and dobutamine in patients with cardiogenic shock. The search strategy involved a comprehensive exploration of electronic databases, including PubMed, EMBASE, Cochrane Library, and Scopus from the the inception of each database up to the 31st of January 2024. A combination of keywords and Medical Subject Headings (MeSH) terms was employed to identify relevant studies. The outcomes assessed in this meta-analysis included all-cause in-hospital mortality, length of intensive care unit (ICU stay), and length of hospital stay. A total of seven studies were included in this meta-analysis enrolling 3,841 patients (2,331 in the dobutamine group and 1,510 in the milrinone group). Pooled analysis showed that the risk of all-cause mortality was significantly higher in patients receiving dobutamine compared to patients receiving milrinone (relative risk (RR): 1.43, 95% confidence interval (CI): 1.02 to 2.01, p-value: 0.04). However, the length of hospital stay and length of ICU stay were not significantly different between the two groups. Limited data are available to favor the use of one inotropic agent over another. Dobutamine might lead to a shorter hospital length of stay, but there is also a risk of increased all-cause mortality. Larger randomized studies with adequate power are needed to validate these observations.