Dobutamine for patients with severe heart failure: a systematic review and meta-analysis of randomised controlled trials
Dobutamine is recommended for patients with severe heart failure; however uncertainty exists as to its effect on mortality. This study aims to critically review the literature to evaluate whether dobutamine, compared with placebo or standard care, is associated with lower mortality and a range of secondary outcomes, in patients with severe heart failure.
A systematic review and meta-analysis of randomised controlled trials was performed. PubMed, EMBASE, the Cochrane Central Trials Registry, the metaRegister of Controlled Trials and bibliographies of retrieved articles were searched. Randomised trials comparing dobutamine with placebo or standard care, in human, adult patients with severe heart failure, were included if they reported at least one outcome of interest. Data regarding trial validity, methodological processes and clinical outcomes were extracted, and a meta-analysis was performed.
Fourteen studies, with 673 participants, met the inclusion criteria and were included; 13 studies reported mortality. There was minimal heterogeneity (I 2 = 4.5%). The estimate of the odds ratio for mortality for patients with severe heart failure treated with dobutamine compared with standard care or placebo was 1.47 (95% confidence interval 0.98–2.21, p = 0.06).
This meta-analysis showed that dobutamine is not associated with improved mortality in patients with heart failure, and there is a suggestion of increased mortality associated with its use, although this did not reach the conventional level of statistical significance. Further research to define the role of dobutamine in treatment of severe heart failure should be a priority.
- Dobutamine for patients with severe heart failure: a systematic review and meta-analysis of randomised controlled trials
Intensive Care Medicine
Volume 38, Issue 3 , pp 359-367
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- Heart failure
- Inotropic agents
- Industry Sectors
- Author Affiliations
- 1. Intensive Care Unit, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia
- 2. Department of Anaesthesia and Critical Care, Belfast City Hospital, Belfast, Northern Ireland
- 3. Northern Clinical School, University of Sydney, St Leonards, Sydney, NSW, Australia