Weaning continuous cardiac inotropes at end of life: case studies and institutional clinical guidelines

The use of long-term, continuous intravenous inotropic support (CIIS) has increased over the past decade. (1) Published evidence indicates that CIIS improves New York Heart Association (NYHA) functional class but does not impact survival. (2) American College of Cardiology/American Heart Association (ACC/AHA) guidelines published in 2013 delineated indications for intravenous inotropic support. (3) Long-term CIIS as palliative therapy (i.e. aim is symptomatic improvement in patients who are not appropriate for surgical therapies) in patients with ACC/AHA Stage D congestive heart failure (CHF) despite optimal medical treatmetn and device therapy was assigned a Class IIb recommendation (Level of Evidence B).
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research