Cochrane · systematic review · CD009669
Inotropic agents and vasodilator strategies for the treatment of cardiogenic shock or low cardiac output syndrome
Uhlig, K, Efremov, L, Tongers, J, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
HeartAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
19
current version
GRADE rated
10
No studies
9
Included studies
NR
No studies 9 · 47.4%Ungraded 0 · 0%Very low 8 · 42.1%Low 2 · 10.5%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Levosimendan compared to dobutamine for cardiogenic shock or low cardiac output syndrome
Population: people with cardiogenic shock or low cardiac output syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause short‐term mortality: range 15 to 31 days Levosimendan vs dobutamine | RR 0.6 [0.36, 1.03] | 4 studies · 1701 participants | Low Downgraded: risk of bias, imprecision |
All‐cause long‐term mortality: range 4 to 12 months Levosimendan vs dobutamine | RR 0.84 [0.63, 1.13] | 4 studies · 1591 participants | Low Downgraded: risk of bias, imprecision |
Levosimendan compared to placebo for cardiogenic shock or low cardiac output syndrome
Population: adults with cardiogenic shock or low cardiac output syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause short‐term mortality: 1 month Levosimendan vs placebo | no estimate extracted | NR | No studies |
All‐cause long‐term mortality: range 4 to 6 months Levosimendan vs placebo | RR 0.55 [0.16, 1.9] | 2 studies · 55 participants | Very low Downgraded: risk of bias, imprecision |
Levosimendan compared to enoximone for cardiogenic shock
Population: adults with cardiogenic shock
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause short‐term mortality: 30 days Levosimendan vs enoximone | RR 0.5 [0.22, 1.14] | 1 study · 32 participants | Very low Downgraded: risk of bias, imprecision |
All‐cause long‐term mortality Levosimendan vs enoximone | no estimate extracted | NR | No studies |
Epinephrine compared to norepinephrine‐dobutamine for cardiogenic shock
Population: adults with cardiogenic shock
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause short‐term mortality: 28 days Epinephrine vs norepinephrine‐dobutamine | RR 1.25 [0.41, 3.77] | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision |
All‐cause long‐term mortality Epinephrine vs norepinephrine‐dobutamine | no estimate extracted | NR | No studies |
Dopexamine compared to dopamine for low cardiac output syndrome
Population: adults with low cardiac output syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause short‐term mortality: time in hospital Dopexamine vs dopamine | no estimate extracted | 1 study · 70 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
All‐cause long‐term mortality Dopexamine vs dopamine | no estimate extracted | NR | No studies |
Milrinone compared to dobutamine for low cardiac output syndrome
Population: adults with low cardiac output syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality Milrinone vs dobutamine | no estimate extracted | NR | No studies |
Enoximone compared to dobutamine for low cardiac output syndrome
Population: adults with low cardiac output syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause short‐term mortality: 1 month Enoximone vs dobutamine | RR 0.21 [0.01, 4.11] | 1 study · 37 participants | Very low Downgraded: risk of bias, imprecision |
All‐cause long‐term mortality Enoximone vs dobutamine | no estimate extracted | NR | No studies |
Epinephrine compared to norepinephrine for cardiogenic shock
Population: adults with cardiogenic shock
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause short‐term mortality: 28 days Epinephrine vs norepinephrine | RR 1.81 [0.89, 3.68] | 1 study · 57 participants | Very low Downgraded: risk of bias, imprecision |
All‐cause long‐term mortality: 60 days Epinephrine vs norepinephrine | RR 1.41 [0.78, 2.56] | 1 study · 57 participants | Very low Downgraded: risk of bias, imprecision |
Dopamine‐milrinone compared to dopamine‐dobutamine for cardiogenic shock
Population: adults with cardiogenic shock
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause short‐term mortality: at intensive care unit Dopamine‐milrinone vs dopamine‐dobutamine | RR 1 [0.34, 2.93] | 1 study · 20 participants | Very low Downgraded: risk of bias, imprecision |
All‐cause long‐term mortality Dopamine‐milrinone vs dopamine‐dobutamine | no estimate extracted | NR | No studies |
Enoximone compared to piroximone for low cardiac output syndrome
Population: adults with low cardiac output syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality Enoximone vs piroximone | no estimate extracted | NR | No studies |
Enoximone compared to epinephrine‐nitroglycerine for low cardiac output syndrome
Population: adults with low cardiac output syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality Enoximone vs epinephrine‐nitroglycerine | no estimate extracted | NR | No studies |