Abstract
BackgroundInotrope score has been proposed as a marker of clinical outcome after adult heart transplantation (HTx) but is rarely used in practice.MethodsInotrope score during the first 48 h after HTx was calculated in 81 patients as: dopamine + dobutamine + amrinone + milrinone (dose × 15) + epinephrine (dose × 100) + norepinephrine (dose × 100) + enoximone + isoprenaline (dose × 100), with each drug in µg/kg/min. Determinants of inotrope score were identified with linear regression. Cox regression was used to determine the association of inotrope score with mortality.ResultsThe mean recipient age was 52 ± 11 years, and 32 (39.5%) patients were female. Determinants of inotrope score were preoperative C‐reactive protein, serum urea, congenital heart disease, and donor cardiac arrest (R2 = .30). Inotrope score was associated with 5‐year mortality, independent of recipient age and gender (HR 1.03, 95% CI 1.00‐1.07). This association was attenuated when adjusting for female‐to‐male transplant and ischemia time. Inotrope score was also strongly associated with continuous veno‐venous hemofiltration (OR 1.07, 95% CI 1.03‐1.12).ConclusionHigh inotrope score post‐HTx was observed in recipient congenital heart disease and was associated with a higher risk of mortality and acute kidney injury.
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