DOBUTAMINE SUMMARY
DOBUTamine
INJECTION, USP
Dobutamine Injection, USP is 1,2-benzenediol, 4-[2-[[3-(4-hydro-xyphenyl)-1-methylpropyl]amino]ethyl]-hydrochloride, (±). It is a synthetic catecholamine.
The clinical formulation is supplied in a sterile form for intravenous use only. Each mL contains: Dobutamine hydrochloride, equivalent to 12.5 mg (41.5 μmol) dobutamine; 0.24 mg sodium metabisulfite (added during manufacture), and water for injection. pH adjusted between 2.5 to 5.5 with hydrochloric acid and/or sodium hydroxide. Dobutamine is oxygen sensitive.
Dobutamine injection is indicated when parenteral therapy is necessary for inotropic support in the short-term treatment of adults with cardiac decompensation due to depressed contractility resulting either from organic heart disease or from cardiac surgical procedures.
In patients who have atrial fibrillation with rapid ventricular response, a digitalis preparation should be used prior to institution of therapy with dobutamine hydrochloride.
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NEWS HIGHLIGHTS
Published Studies Related to Dobutamine
Comparison of norepinephrine-dobutamine to epinephrine for hemodynamics, lactate metabolism, and organ function variables in cardiogenic shock. A prospective, randomized pilot study. [2011.03]
OBJECTIVE: There is no study that has compared, in a randomized manner, which vasopressor is most suitable in optimizing both systemic and regional hemodynamics in cardiogenic shock patients. Hence, the present study was designed to compare epinephrine and norepinephrine-dobutamine in dopamine-resistant cardiogenic shock... CONCLUSIONS: When considering global hemodynamic effects, epinephrine is as effective as norepinephrine-dobutamine. Nevertheless, epinephrine is associated with a transient lactic acidosis, higher heart rate and arrhythmia, and inadequate gastric mucosa perfusion. Thus, the combination norepinephrine-dobutamine appears to be a more reliable and safer strategy.
Acute effects of levosimendan and dobutamine on QRS duration in patients with heart failure. [2010.12]
BACKGROUND: Levosimendan is a novel inotropic agent that enhances cardiac contractility without increasing cellular calcium intake, so that it is not supposed to cause intracellular calcium overload and related arrhythmias. In patients with heart failure, prolonged QRS duration is associated with increased risk of mortality and sudden cardiac death. Structural changes in the left ventricle may lead to asynchronous contraction, causing conduction delay and a prolonged QRS on the surface electrocardiogram. OBJECTIVE: We aimed to compare the acute effects of levosimendan and dobutamine on QRS duration in patients with severe heart failure and sinus rhythm... CONCLUSION: We suggest that the administration of levosimendan, not dobutamine, shortens QRS duration on the surface ECG, possibly by means of providing collective contraction in the left ventricle muscle fibers. The molecular basis of this effect remains to be clarified.
Double-blind placebo-controlled comparison of enoximone and dobutamine infusions in patients with moderate to severe chronic heart failure. [2010.11]
Few data exist on the safety of transferring patients to standard oral therapy for chronic heart failure (CHF) after acute management with inotropic agents. This study compares hemodynamic responses and cardiac dysrhythmic effects of continuous infusion of enoximone, dobutamine, or placebo in patients with moderate to severe CHF...
[Levosimendan and dobutamine have a similar profile for potential risk for cardiac arrhythmias during 24-hour infusion in patients with acute decompensated heart failure]. [2010.07]
OBJECTIVES: Unlike traditional inotropic agents, levosimendan is thought to have a lower potential to induce arrhythmias because it does not increase intracellular calcium levels and myocardial oxygen consumption. We compared the potential effect of levosimendan and dobutamine to induce cardiac arrhythmias in patients with decompensated heart failure... CONCLUSION: Our findings suggest that levosimendan and dobutamine have a similar profile for potential risk for cardiac arrhythmias.
[Efficacy and safety of intravenous levosimendan compared with dobutamine in decompensated heart failure]. [2010.06]
OBJECTIVE: To compare the efficacy and safety of intravenous levosimendan and dobutamine in patients with decompensated heart failure refractory to conventional medications... CONCLUSION: Levosimendan was well tolerated and superior to dobutamine for patients with decompensated heart failure refractory to conventional medications.
Clinical Trials Related to Dobutamine
Norepinephrine Plus Dobutamine Versus Epinephrine Alone for the Management of Septic Shock [Completed]
Catecholamines infusion is a major component of septic shock management. International
guidelines recommend that norepinephrine should be preferred to epinephrine, though phase III
trials are lacking. The present study aimed at comparing the efficacy and safety of
norepinephrine plus dobutamine to that of epinephrine in adults with septic shock.
Dobutamine Echocardiography In Patients With Ischemic Heart Failure Evaluated for Revascularization [Active, not recruiting]
To define the role of the assessment of myocardial viability with dobutamine echocardiography
(DE) in the clinical evaluation and selection of the best treatment for a high-risk subset of
patients with coronary artery disease.
Effects of Dobutamine on Microcirculation, Regional and Peripheral Perfusion in Septic Shock Patients [Recruiting]
The investigators hypothesize that dobutamine is able to revert negative redistribution of
flow by inducing a selective vasodilatory effect on hypoperfused territories, particularly
at the sublingual and gastric mucosa, and at the peripheral tissues.
The investigators designed a randomized, cross-over, placebo-controlled study looking at the
acute physiologic effects of 5 mcg/kg/min fixed-dose of dobutamine on cardiac function,
microcirculation, gastric mucosal, hepatosplanchnic, and peripheral perfusion in septic
shock patients.
Dopamine Versus Dobutamine for Treatment of Arterial Hypotension in Term and Preterm Neonates [Recruiting]
The purpose of this study is to examine the effects of Dobutamine as compared to Dopamine in
term and preterm neonates with arterial hypotension on cerebral and renal oxygenation,
fractional tissue oxygen extraction, mean arterial blood pressure and cardiac output.
The investigators hypothesize that Dopamine has a stronger effect on blood pressure than
Dobutamine but Dobutamine has a stronger effect on cerebral oxygenation and cardiac output
than Dopamine.
Cardiac Allograft Vasculopathy and Dobutamine Stress Echocardiography / Brain Natriuretic Peptide Coupling [Recruiting]
Primary purpose :To early detect cardiac allograft vasculopathy and to identify patients
with high risk of cardiac events, by coupling the analysis of the kinetics of the brain
natriuretic peptide ( BNP) with that of the left ventricle (LV) during a dobutamine stress
echocardiography.
Hypothesis : Plasma BNP elevation and abnormalities of LV kinetic during the ESD, will be
associated with the presence of allograft vasculopathy and the arisen of cardiovascular
events.
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