Abstract
Inotropes and vasopressors are central to the management of critically ill patients with haemodynamic instability. Their use varies widely across intensive care units (ICUs), and standardised prescribing patterns remain limited. This study was undertaken to characterise the indications, utilisation patterns, and clinical outcomes associated with inotropic therapy in a tertiary care ICU. A prospective, observational, longitudinal study was conducted in the ICUs of a tertiary care teaching hospital. Two hundred critically ill patients receiving inotropic support were enrolled. Demographic data, diagnosis, indication, type and number of inotropes, dose, duration, and haemodynamic parameters before and after initiation were recorded using a structured case record form. Data were analysed using descriptive statistics. Of the 200 patients, 59% were male, and most belonged to the 51 75-year age group. Myocardial infarction and acute coronary syndrome accounted for 43.5% of cases and, together with cardiogenic shock (10.5%), were the most common indications for inotrope use. Noradrenaline was the most frequently prescribed agent (68.5%), followed by dobutamine and dopamine. Single-agent therapy was used in most patients, with combination therapy reserved for refractory shock. Haemodynamic parameters improved after inotrope initiation. Overall mortality was 44%, reflecting the severity of underlying illness. Noradrenaline was the most commonly used inotrope among critically ill ICU patients. Prescribing favoured initial single-agent therapy, with combinations reserved for severe cases. Drug-utilisation studies of this kind help promote rational, evidence-based inotrope use in critical care.
Keywords: Inotropes; Noradrenaline; Intensive care unit; Cardiogenic shock; Drug utilisation.