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
The effect of dobutamine on blood flow of free tissue transfer flaps during head and neck reconstructive surgery*. [2009.10]
SUMMARY: In view of the controversy over the use of inotropes in free tissue transfer surgery, we assessed the effect of different intra-operative dobutamine infusion rates on blood flow in the anastomosed recipient artery. Twenty patients undergoing head and neck tumour resection and immediate reconstructive surgery with free tissue transfer were recruited...
Lowered B-type natriuretic peptide in response to levosimendan or dobutamine treatment is associated with improved survival in patients with severe acutely decompensated heart failure. [2009.06.23]
OBJECTIVES: The purpose of this analysis was to examine whether decreases in B-type natriuretic peptide (BNP) levels during the first few days of hospitalization were associated with greater survival in patients with severe acutely decompensated heart failure (ADHF). BACKGROUND: BNP level is a prognostic marker for all-cause mortality (ACM) in ADHF; whether early BNP changes can also help predict outcome in patients who need inotropes for treatment of severe ADHF is not known... CONCLUSIONS: Patients with lowered BNP on treatment for ADHF had reduced mortality risks (31- and 180-day) compared to those with little or no BNP decrease. These results suggest that early lowering of BNP predicts both short- and long-term mortality risks. BNP reduction may therefore serve as a suitable prognostic marker of ACM.
Comparison of ischemic side effects of levosimendan and dobutamine with integrated backscatter analysis. [2009.04]
BACKGROUND: Levosimendan improves cardiac contractility without increasing oxygen consumption. However, its effects on ischemia were not supported with the utilization of a noninvasive parameter of myocardial characterization. HYPOTHESIS: The changes observed in integrated backscatter (IBS) may be reflective of change in myocardial ischemia. In this study, the effect of levosimendan on ischemia detected by IBS was evaluated in patients with ischemic heart failure (HF)... CONCLUSIONS: Unlike dobutamine, levosimendan may not induce myocardial ischemia as shown by CVIBS at commonly used dosages in the setting of decompensated HF without active ischemia.
Levosimendan vs. dobutamine: outcomes for acute heart failure patients on beta-blockers in SURVIVE. [2009.03]
CONCLUSION: Levosimendan may be better than dobutamine for treating patients with a history of CHF or those on beta-blocker therapy when they are hospitalized with acute decompensations. These findings are preliminary but important for planning future studies.
Evaluation of the anti-ischemic effects of D-ribose during dobutamine stress echocardiography: a pilot study. [2009.02.07]
D-Ribose, a pentose sugar, has shown to improve myocardial high-energy phosphate stores depleted by ischemia. This study investigated the ability of D-Ribose with low dose dobutamine to improve the contractile response of viable myocardium to dobutamine and to assess the efficacy of D-ribose in reducing stress-induced ischemia...
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.
Evaluation of Myocardial Viability by Means of Low-Dose Dobutamine Gated SPECT (the DOGS Study) [Completed]
Viability assessment remains a clinical challenge in patient with coronary artery disease and
left ventricular dysfunction. Several imaging modalities are available for evaluating
myocardial viability, based either on perfusion or on contractile reserve analysis. Briefly,
perfusion analysis is highly sensitive and contractile reserve highly specific. A combined
analysis of both perfusion and contractile reserve has been proposed to improve the
diagnostic accuracy in patient referred for a revascularization procedure. However, the value
of this combined analysis has not been validated in unselected patients referred for
viability assessment.
The patients enrolled in the study will undergo a nitrate enhanced rest gated SPECT using a
Tc-99m labeled tracer (sestamibi or tetrofosmine) followed by a second gated SPECT acquired
during a low-dose dobutamine infusion (10 mcg/kg/mn). All patients will have a 6-month
clinical and imaging follow-up, including physical examination and a nitrate enhanced rest
gated SPECT using the same radiopharmaceutical. All treatments received during this 6-month
period will be recorded, including medical therapy and coronary revascularization
(angioplasty, stenting and CABG).
Finally, the value of baseline perfusion and contractile reserve analysis in predicting left
ventricular ejection fraction changes at 6-month follow-up will be evaluated.
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.
Survival of Patients With Acute Heart Failure in Need of Intravenous Inotropic Support: a Multicentre, Parallel-Group, Randomised, Double-Blind, Double-Dummy Study of Levosimendan Versus Dobutamine in Patients With Acute Heart Failure. [Completed]
The primary objective of the study is to compare the efficacy of levosimendan and dobutamine
on all-cause mortality in the 180 days following randomization.
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