Abstract
Some centers in the United States continue to use (periodic) pulsed inotropic therapy in the management of severe congestive heart failure. Although there have been large, randomized, well-designed trials of oral inotropes in chronic heart failure, studies evaluating intravenous agents have been smaller and often of inferior design. Review of available intravenous inotrope studies in chronic congestive heart failure found improved clinical status with treatment. Although studies suggest clinical benefit is achieved at a cost of increased mortality, no study demonstrated a statistically significant difference. Large, randomized studies are needed to define the role of intravenous inotropic therapy in various heart failure groups, establish its safety, and explore its adjunctive use to enhance oral therapy.
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