Reserve Inotropes for Select Cases of Acute or End-Stage Heart Failure
Do the IV inotropes dobutamine and milrinone still have a role in treating heart failure with reduced ejection fraction (HFrEF)?
Yes...but only in a small subset of patients.
Both meds increase arrhythmias. And widespread use fell out of favor years ago...due to concerns about increased mortality, especially in patients withOUT low cardiac output and hypotension.