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A prospective observational study on usage of inotropes in a coronary care unit

Dr. B. Arumugam ,Dr. Y. Nisha Maheswari ,Dr. B.Meenakshi ,Dr. J.Ezhil Ramya ,Dr. A.S.Arul .




Abstract

Background: Treatment with inotropes is generally reserved for most severely ill patients and so increased mortality can be coincidental. Several clinical trials in a wide range of clinical settings have been performed with controversial results to determine the effects of inotropes on mortality. Hence, the present study was done to evaluate the effect of inotropes and vasopressors used in our setting on the outcome of the patients.

Aims and Objectives: This study aims to assess the clinical profile of patients requiring inotropes and their outcomes in a coronary care unit.

Materials and Methods: This prospective, observational, hospital-based study was conducted in intensive coronary care unit (ICCU). Detailed history and findings on clinical examination were recorded. Inotropes used, indication, duration of stay in hospital, various complications, and outcomes were also entered. Patients were monitored daily until their discharge or death.

Results: The total number of patients admitted in ICCU during the study period was 199, of which 25 (12.6%) patients needed inotropes. The most common risk factor for inotrope use was diabetes mellitus (40%). The most common inotrope used was noradrenaline. The average duration of hospital stay for patients requiring inotropes was 4.7 days. Of 25 patients requiring inotropes, 64% (n = 16) survived and 36% (n = 9) expired. Chi-square test revealed that the need of inotropes was significantly associated with increased risk of death.

Conclusion: In the coronary care unit, the use of inotropes was associated with poor outcomes. Inotropes may not be detrimental per se, but accurate benefits and risks and selection of the correct agent are required in every clinical setting.

Key words: Inotropes; Intensive Coronary Care Unit; Clinical Profile; Outcome; Mortality






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