USE OF DOBUTAMINE IN CARDIOGENIC SHOCK: A REVIEW OF THE CURRENT LITERATURE

Abstract

 This article aimed to review, in a structured manner, the role of dobutamine in the management of cardiogenic shock (CS), describing its mechanism of action, indications, dosing, and the current scientific evidence supporting or limiting its use. This is a narrative literature review, with searches conducted in the PubMed/MEDLINE, Cochrane Library, and SciELO databases, prioritizing randomized clinical trials, meta-analyses, and guidelines published mainly between 2018 and 2026. The results show that dobutamine, a predominantly β1-adrenergic agonist, remains one of the most widely used inotropes in normotensive CS or CS stabilized with a vasopressor, being comparable to milrinone in mortality outcomes in randomized trials, although observational studies suggest a higher risk of arrhythmias and mortality associated with its use. It is concluded that dobutamine retains a relevant role as a hemodynamic bridge measure in CS, and its use should be individualized, guided by continuous hemodynamic monitoring, and always associated with investigation of the underlying cause and, when indicated, revascularization or mechanical circulatory support.