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Inotrope Showdown Leaves No Winner in Cardiogenic Shock

email article Against expectations, critically ill people in cardiogenic shock fared similarly receiving one widely used inotrope or another in the small DOREMI trial. Patients had the same clinical outcomes on milrinone and dobutamine in terms of the study s primary composite outcome (RR 0.90, 95% CI 0.69-1.19) and its individual endpoint components: In-hospital death: 37% vs 43% (RR 0.85, 95% CI 0.60-1.21) Resuscitated cardiac arrest: 7% vs 9% (HR 0.78, 95% CI 0.29-2.07) Receipt of mechanical circulatory support or cardiac transplant: 12% vs 15% (HR 0.78, 95% CI 0.36-1.71) Nonfatal myocardial infarction: 1% vs 0% Stroke or transient ischemic attach: 1% vs 2% (HR 0.50, 95% CI 0.05-5.50) Initiation of renal replacement therapy: 22% vs 17% (HR 1.39, 95% CI 0.73-2.67) Moreover, we did not identify any significant between-group differences in safety outcomes or in surrogate markers of resuscitation, including heart rate, blood pressure, and serum lactate level, reported

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