Observational studyCritical care (London, England)2018
Intraoperative milrinone versus dobutamine in cardiac surgery patients: a retrospective cohort study on mortality.
Observational study in Critical care (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
10 citing papers in PubMed, 28 citations in OpenAlex.
- Efficacy and safety of dobutamine versus milrinone in cardiogenic shock: Systematic review and meta-analysis.Global cardiology science & practice · 2026Article
- A simple transseptal approach versus the conventional left atrial approach for mitral valve procedures: a retrospective study.Indian journal of thoracic and cardiovascular surgery · 2024Article
- Perioperative approach to precapillary pulmonary hypertension in non-cardiac non-obstetric surgery.European respiratory review : an official journal of the European Respiratory Society · 2021Review
- Application of the Care Bundle in Perioperative Nursing Care of the Type A Aortic Dissection.International journal of general medicine · 2021Article
- Use of Vasoactive Medications after Cardiac Surgery in the United States.Annals of the American Thoracic Society · 2021Article
- Impact of the perioperative inotropic support in grown-up congenital heart patients undergoing cardiac surgery: a propensity score adjusted analysis.Annals of intensive care · 2020Article
- Perioperative management of patients with undergoing durable mechanical circulatory support.Annals of translational medicine · 2020Review
- Comparison of Positive Inotropic Agents in the Management of Acute Decompensated Heart Failure.Journal of cardiovascular pharmacology · 2020Article
- Does Inhaled Milrinone Facilitate Weaning From Cardiopulmonary Bypass in Children with Congenital Heart Diseases Complicated with Pulmonary Arterial Hypertension?Turkish journal of anaesthesiology and reanimation · 2020Article
- Use of Levosimendan in Intensive Care Unit Settings: An Opinion Paper.Journal of cardiovascular pharmacology · 2019Review
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundSeveral choices of inotropic therapy are available and used in relation to cardiac surgery. Comparisons are necessary to select optimal therapy. In Denmark, dobutamine and milrinone are the two inotropic agents most commonly used to treat post-bypass low cardiac output syndrome. This study compares all-cause mortality with these drugs.
methodsIn a retrospective observational study we investigated 10,700 consecutive patients undergoing cardiac surgery from 1 April 2006 to 31 December 2013 at Aarhus and Aalborg University Hospitals in the Central and Northern Denmark Region. Prospectively entered data in the Western Danish Heart Registry on intraoperative use of inotropes were used to identify 952 patients treated with milrinone, 418 patients treated with dobutamine, and 82 patients receiving a combination of the two inotropes. All-cause mortality among patients receiving dobutamine was compared to all-cause mortality among milrinone receivers. Multiple logistic regression analyses including preoperative and intraoperative variables along with g-formula analyses were used to model 30-day and 1-year mortality risks. Reported were standardized mortality risk differences between the treatment groups.
resultsAmong patients receiving intraoperative dobutamine, 18 (4.3%) died within 30 days and 49 (11.7%) within 1 year. Corresponding 30-day and 1-year mortality for milrinone receivers were 81 (8.5%) and 170 (17.9%). Risk of death within 30 days and 1 year was increased for intraoperative milrinone compared to dobutamine with a standardized risk difference of 4.06% (confidence interval (CI) 1.23; 6.89, p = 0.005) and 4.77% (CI 0.39; 9.15, p = 0.033), respectively. Sensitivity analyses including adjustment for milrinone preference, hemodynamic instability prior to cardiopulmonary bypass, and separate analyses on hospital level all confirmed a sign toward increased mortality among milrinone receivers.
conclusionsIntraoperative use of milrinone in cardiac surgery may be associated with an increase in all-cause mortality compared to use of dobutamine.
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