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Potent inotropic and mild vasodilatory and chronotropic effects
β1 > β2 > α1
increased contractility and heart rate with neutral effect or possible decrease in blood pressure !
Initiation of inotropic support, with an agent such as epinephrine or dobutamine,
is most appropriate to improve heart rate, contractility, and augment cardiac output.
Dobutamine (Gendobu) 250mg/20ml/vial
- 500 mg dobutamine in D5W/NS 85 mL (125ml), concentration 4 mg/mL
- Cardiac decompensation : Start at 2 mcg/kg/min, range 0-20 mcg/kg/min
(run 0-20 ml/hr in 70kg)
- 500 mg dobutamine in NS 85 mL, concentration 4 mg/mL
- Cardiac decompensation: Start at 2 mcg/kg/min (2.25ml/hr), range 0-20 mcg/kg/min (0-18ml/hr)
- Goal: Cardiac Index >= 2.2 L/min/m2
【Dilution/Conc】500 mg dobutamine in D5W/NS 85 mL, concentration 4 mg/mL
【Rate】Cardiac decompensation: Start at 2 mcg/kg/min, range 0-20 mcg/kg/min
【Goal】Cardiac Index ≧ 2.2 L/min/m2
【Monitor】old if Systolic BP < 90 mmHg or mean arterial pressure < 65 mmHg
【Titration/Taper】
# Titration：check BP Q5-15 min and increase by 0.5-2 mcg/kg/min
# Taper (by clinical judgement)：check BP Q15-30 min and decrease by 0.5-1 mcg/kg/min
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