Table 1

Inotropic agents used in heart failure, dosings, class of recommendation and level of evidence for recommendation according to the European Society of Cardiology 2008 guidelines on diagnosis and management of acute and chronic heart failure7

Inotropic agentsBolus dosingInfusion rateClass of recommendationLevel of evidence
DobutamineNo2–20 mg/kg/min (β+)IIaB
DopamineNo

  • <3 mg/kg/min: renal effect (dopaminergic+)

  • 3–5 mg/kg/min: inotropic (β+)

  • >5 mg/kg/min: inotropic (β+) and vasopressor (α+)

IIbC
Milrinone25–75 μg/kg over 10–20 min0.375–0.75 μg/kg/minIIbB
Enoximone0.25–0.75 mg/kg1.25–7.5 mg/kg/minIIbB
Levosimendan12 μg/kg over 10 min (optional)0.1 μg/kg/min Which can be decreased to 0.05 or increased to 0.2 mg/kg/minIIaB
NorepinephrineNo0.2–1.0 μg/kg/minIIbC
EpinephrineBolus: 1 mg can be given intravenously. During resuscitation, repeated every 3–5 min0.05–0.5 μg/kg/minIIbC