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dc.contributor.authorMøller, M. H.
dc.contributor.authorGranholm, A.
dc.contributor.authorJunttila, E.
dc.contributor.authorHaney, M.
dc.contributor.authorOscarsson-Tibblin, A.
dc.contributor.authorHaavind, A.
dc.contributor.authorLaake, J. H.
dc.contributor.authorWilkman, E.
dc.contributor.authorSverrisson, K. Ö.
dc.contributor.authorPerner, A.
dc.date.accessioned2018-05-24T10:31:07Z
dc.date.available2018-05-24T10:31:07Z
dc.date.issued2018-04
dc.date.submitted2018
dc.identifier.citationScandinavian SSAI clinical practice guideline on choice of inotropic agent for patients with acute circulatory failure 2018, 62 (4):420 Acta Anaesthesiologica Scandinavicaen
dc.identifier.issn00015172
dc.identifier.doi10.1111/aas.13089
dc.identifier.urihttp://hdl.handle.net/2336/620565
dc.descriptionTo access publisher's full text version of this article click on the hyperlink belowen
dc.description.abstractBACKGROUND: Adult critically ill patients often suffer from acute circulatory failure and those with low cardiac output may be treated with inotropic agents. The aim of this Scandinavian Society of Anaesthesiology and Intensive Care Medicine guideline was to present patient-important treatment recommendations on this topic. METHODS: This guideline was developed according to GRADE. We assessed the following subpopulations of patients with shock: (1) shock in general, (2) septic shock, (3) cardiogenic shock, (4) hypovolemic shock, (5) shock after cardiac surgery, and (6) other types of shock, including vasodilatory shock. We assessed patient-important outcome measures, including mortality and serious adverse reactions. RESULTS: For all patients, we suggest against the routine use of any inotropic agent, including dobutamine, as compared to placebo/no treatment (very low quality of evidence). For patients with shock in general, and in those with septic and other types of shock, we suggest using dobutamine rather than levosimendan or epinephrine (very low quality of evidence). For patients with cardiogenic shock and in those with shock after cardiac surgery, we suggest using dobutamine rather than milrinone (very low quality of evidence). For the other clinical questions, we refrained from giving any recommendations or suggestions. CONCLUSIONS: We suggest against the routine use of any inotropic agent in adult patients with shock. If used, we suggest using dobutamine rather than other inotropic agents for the majority of patients, however, the quality of evidence was very low, implying high uncertainty on the balance between the benefits and harms of inotropic agents.
dc.description.sponsorshipScandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI)en
dc.language.isoenen
dc.publisherWileyen
dc.relation.urlhttp://doi.wiley.com/10.1111/aas.13089en
dc.rightsArchived with thanks to Acta Anaesthesiologica Scandinavicaen
dc.subjectHjartabilunen
dc.subjectLyfjagjöfen
dc.subjectAAA12
dc.subject.meshHeart Failureen
dc.subject.meshCardiotonic Agentsen
dc.titleScandinavian SSAI clinical practice guideline on choice of inotropic agent for patients with acute circulatory failureen
dc.typeArticleen
dc.contributor.department[ 1 ] Rigshosp, Copenhagen Univ Hosp, Dept Intens Care 4131, Blegdamsvej 9, DK-2100 Copenhagen, Denmark Show more [ 2 ] Tampere Univ Hosp, Dept Anaesthesiol, Tampere, Finland Show more [ 3 ] Umea Univ, Anaesthesiol & Intens Care Med, Umea, Sweden Show more [ 4 ] Linkoping Univ, Dept Anaesthesiol & Intens Care, Dept Med & Hlth, Linkoping, Sweden Show more [ 5 ] Univ Hosp Northern Norway, Dept Anaesthesiol & Intens Care, Tromso, Norway Show more [ 6 ] Oslo Univ Hosp, Div Crit Care, Oslo, Norway Show more [ 7 ] Univ Helsinki, Helsinki Univ Hosp, Dept Perioperat Intens Care & Pain Med, Div Intens Care Med, Helsinki, Finland Show more [ 8 ] Landspitali Univ Hosp Iceland, Dept Anesthesia & Crit Care, Reykjavik, Icelanden
dc.identifier.journalActa Anaesthesiologica Scandinavicaen
dc.rights.accessOpen Access - Opinn aðganguren
dc.contributor.institutionDepartment of Intensive Care 4131; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
dc.contributor.institutionDepartment of Intensive Care 4131; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
dc.contributor.institutionDepartment of Anaesthesiology; Tampere University Hospital; Tampere Finland
dc.contributor.institutionAnaesthesiology and Intensive Care Medicine; Umeå University; Umeå Sweden
dc.contributor.institutionDepartment of Anaesthesiology and Intensive Care; Department of Medicine and Health; Linköping University; Linköping Sweden
dc.contributor.institutionDepartment of Anaesthesiology and Intensive Care; University Hospital Northern Norway; Tromsø Norway
dc.contributor.institutionDivision of Critical Care; Oslo University Hospital; Oslo Norway
dc.contributor.institutionDivision of Intensive Care Medicine; Department of Perioperative, Intensive Care and Pain Medicine; Helsinki University Hospital; University of Helsinki; Helsinki Finland
dc.contributor.institutionDepartment of Anesthesia & Critical Care; Landspitali University Hospital of Iceland; Reykjavik Iceland
dc.contributor.institutionDepartment of Intensive Care 4131; Copenhagen University Hospital, Rigshospitalet; Copenhagen Denmark
dc.departmentcodeAAA12
refterms.dateFOA2018-09-12T17:14:12Z
html.description.abstractBACKGROUND: Adult critically ill patients often suffer from acute circulatory failure and those with low cardiac output may be treated with inotropic agents. The aim of this Scandinavian Society of Anaesthesiology and Intensive Care Medicine guideline was to present patient-important treatment recommendations on this topic. METHODS: This guideline was developed according to GRADE. We assessed the following subpopulations of patients with shock: (1) shock in general, (2) septic shock, (3) cardiogenic shock, (4) hypovolemic shock, (5) shock after cardiac surgery, and (6) other types of shock, including vasodilatory shock. We assessed patient-important outcome measures, including mortality and serious adverse reactions. RESULTS: For all patients, we suggest against the routine use of any inotropic agent, including dobutamine, as compared to placebo/no treatment (very low quality of evidence). For patients with shock in general, and in those with septic and other types of shock, we suggest using dobutamine rather than levosimendan or epinephrine (very low quality of evidence). For patients with cardiogenic shock and in those with shock after cardiac surgery, we suggest using dobutamine rather than milrinone (very low quality of evidence). For the other clinical questions, we refrained from giving any recommendations or suggestions. CONCLUSIONS: We suggest against the routine use of any inotropic agent in adult patients with shock. If used, we suggest using dobutamine rather than other inotropic agents for the majority of patients, however, the quality of evidence was very low, implying high uncertainty on the balance between the benefits and harms of inotropic agents.


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