Indication
Decompensated HF with low CO not responsive to standard therapy; bridge to transplant/LVAD.
Preparation
20 mg in 100 mL D5W or NS.
Dilution
200 mcg/mL
Rate
Optional load 25–50 mcg/kg over 10 min (often omitted); infusion 0.125–0.75 mcg/kg/min.
Monitoring
- • ECG, BP, K+/Mg
- • Platelets (thrombocytopenia)
- • Renal function (adjust)
Common errors
- • Load causes hypotension — often omit in decompensated HF
- • Accumulation in CrCl <30
Pearls
- • Preferred inotrope if on β-blocker (bypasses β receptor)
- • Pulmonary vasodilator — useful in RV failure
