From the Guidelines
Dobutamine is used to treat conditions such as acute heart failure, cardiogenic shock, and septic shock with persistent hypoperfusion.
Conditions Treated by Dobutamine
- Acute Heart Failure: Dobutamine may be used in patients with no beta-blockers to improve cardiac output and blood pressure 1.
- Cardiogenic Shock: Dobutamine is used to increase cardiac output and improve organ perfusion in patients with cardiogenic shock, especially those with low cardiac output 1.
- Septic Shock: Dobutamine is suggested for use in patients with septic shock who show evidence of persistent hypoperfusion despite adequate fluid loading and the use of vasopressor agents 1.
Important Considerations
- Dosing: Low-dose dobutamine (2 to 5 µg/kg per min) is frequently sufficient, while larger doses may produce tachycardia, ventricular arrhythmias, hypokalemia, and myocardial ischemia 1.
- Combination Therapy: The combination of dobutamine and phosphodiesterase inhibitors may produce a positive inotropic effect greater than either drug alone 1.
- Tolerance and Weaning: Prolonged infusion of dobutamine may lead to tolerance and partial loss of hemodynamic effects, and weaning from dobutamine can be difficult 1.
From the FDA Drug Label
Dobutamine Injection, USP is indicated when parenteral therapy is necessary for inotropic support in the short-term treatment of patients with cardiac decompensation due to depressed contractility resulting either from organic heart disease or from cardiac surgical procedures
- Cardiac conditions that dobutamine treats include:
- Cardiac decompensation
- Depressed contractility due to:
- Organic heart disease
- Cardiac surgical procedures 2
From the Research
Conditions Treated by Dobutamine
- Congestive heart failure (CHF) 3, 4, 5
- Refractory CHF 3
- Severe heart failure 4
- Low output cardiac failure 6
- Cardiogenic shock 7
- Advanced refractory heart failure 7
Mechanism of Action
- Increases cardiac contractility and causes vasodilation with little change in heart rate 3
- Increases myocardial contractility and cardiac output 5, 6
- Stimulates beta 1-, beta 2-, and alpha 1-adrenoceptors in the cardiovascular system 6
Administration and Effects
- Routinely administered for short periods to relieve exacerbations of CHF in hospitalized patients 3
- Can be used for long-term therapy to lessen symptoms of CHF and improve exercise tolerance and cardiac function 3, 5
- May cause sudden death, requiring careful monitoring of patients receiving this therapy 3
- Can cause myoclonus, particularly in patients with severe kidney failure 7