Clinical Investigations: SurgeryComparison of dobutamine versus milrinone therapy in hospitalized patients awaiting cardiac transplantation: A prospective, randomized trial☆,☆☆,★
Section snippets
Methods
Patients for this study were recruited from the adult cardiac transplant waiting list at the Shands Transplant Center at the University of Florida. The criteria for entry into the study included age >18 years, prior approval for cardiac transplantation, and exacerbation of heart failure not only necessitating hospitalization but demonstrating inotropic dependency. Inotropic dependency was defined as >2 admissions for decompensated heart failure requiring inotropes from the time of referral to
Results
From January 1999 to May 2000, 36 patients listed as United Network Organ Sharing status 1B were randomly assigned to receive dobutamine (n = 17) or milrinone (n = 19). Baseline characteristics of these patients are summarized in Table I.Empty Cell Dobutamine (n = 19) Milrinone (n = 17) P Age (y) 54 ± 9 61 ± 8 .01 Sex (%) Male 17 (89) 10 (59) .045 Female 2 (11) 7 (41) Race (%) White 18 (95) 16 (94) .73 African American 1 (5) 1 (6) Etiology of congestive heart
Discussion
Despite the absence of randomized trials comparing dobutamine with milrinone in patients awaiting heart transplantation, many transplant clinicians use milrinone as initial inotropic therapy in these patients. Observations from this prospective, randomized trial suggest that either dobutamine or milrinone can be used successfully as pharmacologic therapy for a bridge to heart transplantation.
Small, systematic, observational reviews have suggested that milrinone used as an initial inotropic
Acknowledgements
The authors thank Melanie Fridl Ross, MSJ, ELS, for editorial assistance, and Lisa A. Hamilton, MA, for manuscript preparation.
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Reprint requests: Juan M. Aranda, Jr, MD, University of Florida College of Medicine, Heart Transplant/Heart Failure Program, 1600 SW Archer Rd, Room 10-539, Gainesville, FL 32610-0395.
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E-mail: [email protected]
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0002-8703/2003/$30.00 + 0