The prescribing pattern of dopamine and dobutamine in congestive heart failure patients in a tertiary care teaching hospital

Abstract

Heart failure is a complex syndrome that is associated with profound disease morbidity and mortality and has an adverse impact on the quality of life. The objective of the study was to evaluate the safety and efficacy of Dobutamine & Dopamine inotropes in severe congestive heart failure patients. This prospective study was carried out in patients with left ventricular ejection fraction below 35% requiring hospitalization and on intravenous inotropic therapy for a period of 3 months. The data on patient demographics, etiology, clinical presentation, hemodynamic parameters, physical examination, laboratory parameters, route of administration of the inotropic drug, adverse events and length of the stay were recorded in the data collection form. The collected data were statistically analyzed using SPSS 16.0 version software. The study population comprised of 25 patients among these, 19 were on dobutamine, 3 were on dopamine and 3 were on combination therapy. There was significant improvement in the creatinine clearance after the therapy. Most commonly found adverse events was hypokalemia (28 %) followed by hyperkalemia (16 %), phlebitis (16 %), atrial fibrillation (8 %), hypovolemia & hyponatremia (4 %), pricking & redness at IV site (4 %). Sudden bradycardia was observed in one patient and death occurred in one patient. Majority of patients were administered medications through external jugular vein (EJV) (n=14; 56%). The most commonly prescribed inotrope was dobutamine and there was an improvement in the kidney function after inotropic therapy. The patients who received inotropes through peripheral IV lines were susceptible to phlebitis.